Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women

Lundgren, Ewa; Rastad, Jonas; Thurfjell, Erik; Åkerström, Göran; Ljunghall, Sverker

doi:10.1016/s0039-6060(97)90357-3

Cited by 294 publications

(242 citation statements)

References 27 publications

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“…Con®rmation of HPT on the basis of surgery or cytology (ultrasound-guided ®ne-needle aspiration), or both, was available in more than 70% of the patients. Concerning primary HPT in particular, diagnosis of the condition was not systematically linked to frankly increased serum calcium concentrations, as previously reported also by others (33,41).…”

Section: Methodssupporting

confidence: 77%

Retrospective analysis of the association of nodular goiter with primary and secondary hyperparathyroidism

Dell'Erba

Baldari

Borsato³

et al. 2001

Eur J Endocrinol

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Background: The association of hyperparathyroidism (HPT) with thyroid disease has long been known, but the mechanisms underlying such an association have not yet been clari®ed. Objective: To elucidate the main factors determining this combination of endocrine diseases, in a retrospective multicenter study. Methods: We retrospectively reviewed all patients referred for parathyroid scintigraphy in the period 1990±1999. A total of 487 patients in the age range 17±65 years were selected for the analysis (339 women and 148 men); group A included 241 patients with primary and group B 246 patients with secondary HPT. Results: A total of 124/241 patients in group A (51.5%), but only 92/246 patients in group B (38.2%) had thyroid disorders (notably nodular goiter) associated with HPT P 0X0035X Thyroid disorders were evenly distributed throughout the entire 17±65 years age range in group A, but 17± 40-year-old patients in group B had signi®cantly fewer thyroid disorders than the older patients of the same group (15.5% compared with 43.3%, P , 0X002), as expected in a general population. In patients with primary HPT there was no difference in the prevalence of thyroid disease between women and men, whereas the ratio of women to men in secondary HPT patients with thyroid disease was about 3:1.Conclusions: These results demonstrate an increased prevalence of nodular goiter in patients with primary rather than secondary HPT, and are consistent with a possible role of increased endogenous calcium concentrations (a hallmark of primary, but not of secondary, HPT) as a goitrogenic factor in patients with HPT.

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Section: Methodssupporting

confidence: 77%

Retrospective analysis of the association of nodular goiter with primary and secondary hyperparathyroidism

Dell'Erba

Baldari

Borsato³

et al. 2001

Eur J Endocrinol

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“…This condition is commonly caused by parathyroid adenoma, a benign type of tumour in 85% of the cases; parathyroid carcinoma is rare [156]. Apart from surgical therapy, there is no effective treatment for pHPT, and …”

Section: Parathyroid Adenomamentioning

confidence: 99%

Secreted frizzled related proteins: Implications in cancers

Surana

Sikka

Cai

et al. 2014

Biochimica et Biophysica Acta (BBA) - Reviews on Cancer

103

114

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“…Of all patients diagnosed with pHPT, 5%-28% have the mild form of the disease [19][20][21][22][23][24][25]. In a large series, the distribution of all patients with mild pHPT was 68.6% NHHPT and 31.4% NCHPT [26].The NIH has had three international workshops on asymptomatic hyperparathyroidism [10,27,28].…”

Section: Introductionmentioning

confidence: 99%

Mild Primary Hyperparathyroidism: A Literature Review

Applewhite

Schneider

2014

The Oncologist

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The biochemical profile of classic primary hyperparathyroidism (pHPT) consists of both elevated calcium and parathyroid hormone levels. The standard of care is parathyroidectomy unless prohibited by medical comorbidities. Because more patients are undergoing routine bone density evaluation and neck imaging studies for other purposes, there is a subset of people identified with a biochemically mild form of the pHPT that expresses itself as either elevated calcium or parathyroid hormone levels. These patients often do not fall into the criteria for operation based on the National Institutes of Health consensus guidelines, and they can present a challenge of diagnosis and management. The purpose of this paper is to review the available literature on mild pHPT in an effort to better characterize this patient population and to determine whether patients benefit from parathyroidectomy. Evidence suggests that there are patients with mild pHPTwho have overt symptoms that are found to improve after parathyroidectomy. There is also a group of patients with biochemically mild pHPT who are found to progress to classic pHPT over time; however, it is not predictable which group of patients this will be. Early intervention for this group with mild pHPT may prevent progression of bone, psychiatric, and renal complications, and parathyroidectomy has proven safe in appropriately selected patients at high volume centers. The Oncologist 2014;19:919-929 Implications for Practice: Mild primary hyperparathyroidism (pHPT) is a disease that is being diagnosed with increased frequency; however, recommendations for treatment are not uniform. Current NIH guidelines do not recommend parathyroidectomy for these patients if they are asymptomatic; however, upon focused questioning, many of these patients are found to have subtle symptoms.The biochemically mild nature of the disease has been found to delay diagnosis and treatment, but after it is identified, surgery has shown to provide an improvement in quality of life and bone health. Although the current body of literature suggests that patients with mild pHPT benefit from parathyroidectomy, careful patient and surgeon selection is critical to ensuring safety and efficacy. Universal acceptance of parathyroidectomy in this subset of patients will require more high quality, prospective studies and improved definitions of long-term cure.

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Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women

Cited by 294 publications

References 27 publications

Retrospective analysis of the association of nodular goiter with primary and secondary hyperparathyroidism

Retrospective analysis of the association of nodular goiter with primary and secondary hyperparathyroidism

Secreted frizzled related proteins: Implications in cancers

Mild Primary Hyperparathyroidism: A Literature Review

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