Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fourth International Workshop

Bilezikian, John P.; Brandi, Maria Luisa; Eastell, Richard; Silverberg, Shonni J.; Udelsman, Robert; Marcocci, Claudio; Potts, John T.

doi:10.1210/jc.2014-1413

Cited by 1,332 publications

(1,083 citation statements)

References 11 publications

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“…Near-normal calcium levels may be found in mild PHPT (normocalcaemic primary hyperparathyroidism). In such cases, calcium levels should be measured several times and albumin-corrected calcium levels should be calculated (18 D levels of at least 20-30 ng/mL), avoiding hydroxylated derivatives; iii) physical activity should be encouraged; iv) adequate hydration (at least 6-8 glasses of water per day) should be encouraged to reduce the risk of nephrolithiasis.…”

Section: Diagnosis and Differential Diagnosesmentioning

confidence: 99%

Guidelines for the diagnosis, prevention and management of osteoporosis

et al. 2016

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Osteoporosis poses a significant public health issue. National Societies have developed Guidelines for the diagnosis and treatment of this disorder with an effort of adapting specific tools for risk assessment on the peculiar characteristics of a given population. The Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS) has recently revised the previously published Guidelines on the diagnosis, riskassessment, prevention and management of primary and secondary osteoporosis. The guidelines were first drafted by a working group and then approved by the board of SIOMMMS. Subsequently they received also the endorsement of other major Scientific Societies that deal with bone metabolic disease. These recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on leading experts' experience and opinion, and on good clinical practice. The osteoporosis prevention should be based on the elimination of specific risk factors. The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk, and this is the case only when the risk of fracture is rather high as measured with variables susceptible to pharmacological effect. DeFRA (FRAX® derived fracture risk assessment) is recognized as a useful tool for easily estimate the long-term fracture risk. Several secondary forms of osteoporosis require a specific diagnostic and therapeutic management

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Section: Diagnosis and Differential Diagnosesmentioning

confidence: 99%

Guidelines for the diagnosis, prevention and management of osteoporosis

et al. 2016

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“…In asymptomatic hyperparathyroidism, surgery is indicated in the following cases: a) serum calcium 1mg/dL above of the normal range; b) bone densitometry T-score < -2.5 in lumbar spine, neck of the femur, total hip, or distal third of the radius and/or vertebral fracture in radiography, computed tomography (CT), magnetic resonance imaging (MRI) or vertebral fracture assessment (VFA); c) creatinine clearance < 60 mL/min or urinary calcium > 400 mg/day, and increased risk of lithiasis, or presence of nephrolithiasis or nephrocalcinosis in radiography, CT or ultrasound; d) age < 50 years old (5).…”

Section: Introductionmentioning

confidence: 99%

Association between atypical parathyroid adenoma and neurofibromatosis

Favere

Tsukumo

Matos

et al. 2015

Arch. Endocrinol. Metab.

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“…Criteria for surgery in the general population include a serum calcium of 1.0 mg/dL or more above the upper limit of normal, estimated glomerular filtration rate <60 mL/ min, low bone density (T-score less than −2.5), 24-hour urinary calcium >400 mg/day, nephrolithiasis or nephrocalcinosis, and age <50 years (12). Total serum calcium declines during gestation, likely due to plasma volume expansion.…”

Section: Discussionmentioning

confidence: 99%

Primary Hyperparathyroidism In A First-Trimester Woman With Hyperemesis Gravidarum And Pancreatitis

Burks

Harary

Solórzano

et al. 2017

AACE Clinical Case Reports

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Objective: Primary hyperparathyroidism during pregnancy is rare and is most often due to a solitary parathyroid adenoma. It is usually asymptomatic, but symptoms of hypercalcemia may be difficult to diagnosis, as they are often similar to those of pregnancy, such as fatigue and vomiting. If untreated, there is a high risk of both fetal and maternal complications. Early recognition and treatment are crucial to preventing long-term or lethal consequences. We present a case of severe primary hyperparathyroidism due to a parathyroid adenoma in a 31-year-old G3P2 female which required urgent parathyroidectomy.Methods: Case identified is described. Results:The patient was admitted at 11 weeks of gestation for refractory nausea and vomiting. Laboratory results were diagnostic for primary hyperparathyroidism and showed an elevated calcium of 12.6 mg/dL, elevated parathyroid hormone of 103 pg/mL, and low phosphorus of 1.6 mg/dL. Albumin level was normal. 25-Hydroxyvitamin D was low/normal at 25 ng/mL and 1,25-dihydroxyvitamin D level was elevated at 129 pg/mL. Amylase and lipase levels were elevated, demonstrating concomitant pancreatitis. Thyroid/neck ultrasound showed a 1.0 × 0.6 × 0.4 cm right, lower parathyroid adenoma. She was treated for pancreatitis, and a parathyroidectomy was planned for the second trimester. She returned days later with persistent nausea and vomiting and worsening hypercalcemia to a level of 14.1 mg/dL. Urgent parathyroidectomy was performed with a good outcome.Conclusion: Primary hyperparathyroidism in pregnancy is rare but must be recognized and treated to reduce maternal and fetal complications. (AACE Clinical Case Rep. 2017;3:e31-e34)

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Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fourth International Workshop

Cited by 1,332 publications

References 11 publications

Guidelines for the diagnosis, prevention and management of osteoporosis

Guidelines for the diagnosis, prevention and management of osteoporosis

Association between atypical parathyroid adenoma and neurofibromatosis

Primary Hyperparathyroidism In A First-Trimester Woman With Hyperemesis Gravidarum And Pancreatitis

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