Primary Hyperparathyroidism.
J Clin Endocrinol Metab
; 103(11): 3993-4004, 2018 11 01.
Article
em En
| MEDLINE
| ID: mdl-30060226
ABSTRACT
Background:
Primary hyperparathyroidism (PHPT), the most common cause of hypercalcemia, is most often identified in postmenopausal women. The clinical presentation of PHPT has evolved over the past 40 years to include three distinct clinical phenotypes, each of which has been studied in detail and has led to evolving concepts about target organ involvement, natural history, and management.Methods:
In the present review, I provide an evidence-based summary of this disorder as it has been studied worldwide, citing key concepts and data that have helped to shape our concepts about this disease.Results:
PHPT is now recognized to include three clinical phenotypes overt target organ involvement, mild asymptomatic hypercalcemia, and high PTH levels with persistently normal albumin-corrected and ionized serum calcium values. The factors that determine which of these clinical presentations is more likely to predominate in a given country include the extent to which biochemical screening is used, vitamin D deficiency is present, and whether parathyroid hormone levels are routinely measured in the evaluation of low bone density or frank osteoporosis. Guidelines for parathyroidectomy apply to all three clinical forms of the disease. If surgical guidelines are not met, parathyroidectomy can also be an appropriate option if no medical contraindications are present. If either the serum calcium or bone mineral density is of concern and surgery is not an option, pharmacological approaches are available and effective.Conclusions:
Advances in our knowledge of PHPT have guided new concepts in diagnosis and management.
Texto completo:
1
Coleções:
01-internacional
Temas:
Fomentar_producao_conhecimento_especifico
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Hormônio Paratireóideo
/
Medicina Baseada em Evidências
/
Hiperparatireoidismo Primário
/
Hipercalcemia
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Endocrinol Metab
Ano de publicação:
2018
Tipo de documento:
Article