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Assessment of Hyperparathyroidism

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Tips and Tricks in Endocrine Surgery

Abstract

Parathyroid hormone (PTH) in concert with 1,25-dihydroxyvitamin D regulates the level of calcium and phosphate from skeletal, renal, and intestinal actions. Hyperparathyroidism (HPT) is a common endocrinological disease characterized by an elevated parathyroid hormone (PTH). Hyperparathyroidism can be primary (autonomous hyperfunction of one or more parathyroid glands), secondary (physiological response to hypocalcemia due to an underlying disease), or tertiary (post renal transplantation).

Primary HPT may be minimally symptomatic and coincidentally found. However, the signs and symptoms of hypercalcemia include renal, neurocognitive, musculoskeletal, gastrointestinal, and cardiovascular manifestations. Differential diagnoses that should be considered include vitamin D deficiency, malignancy, familial hypocalciuric hypercalcemia, and lithium or thiazide therapy.

The definitive treatment of primary HPT is parathyroidectomy; however, the clinical and biochemical features may suggest that observation alone is optimal for the patient.

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Abbreviations

BMD:

Bone mineral density

CaE:

Fractional excretion of calcium

CaHPO4 :

Calcium phosphate

CaSR:

Calcium-sensing receptor

dRTA:

Distal renal tubular acidosis

FHH:

Familial hypocalciuric hypercalcemia

MEN:

Multiple endocrine neoplasia

PHPT:

Primary hyperparathyroidism

PTA:

Proximal renal tubular acidosis

PTH:

Parathyroid hormone

PTHrP:

Parathormone-related peptide

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Correspondence to Stephen L. Atkin MBBS, FRCP, PhD .

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© 2014 Springer-Verlag London

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Konya, J., Aye, M., England, R.J., Atkin, S.L. (2014). Assessment of Hyperparathyroidism. In: Watkinson, J., Scott-Coombes, D. (eds) Tips and Tricks in Endocrine Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-2146-6_31

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  • DOI: https://doi.org/10.1007/978-1-4471-2146-6_31

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