Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism

  • In 2014, the fourth international workshop released guidelines for the surgical management of asymptomatic PHPT
  • Guidelines for surgery in asymptomatic PHPT include:
    • Age less than:
      • 50 years old
    • A serum calcium measurement:
      • 1.0 mg/dL (0.25 mmol/L) above the upper limit of normal
    • Bone mineral density by dual-energy x-ray absorptiometry (DXA):
      • With a T-score < −2.5 at lumbar spine, total hip, femoral neck, or distal 1/3 radius
      • Vertebral fracture on x-ray, computed tomography (CT), magnetic resonance imaging (MRI)
    • 24-h urine for calcium:
      • > 400 mg/day (>10 mmol/day)
    • Increased risk of stone formation on biochemical stone risk analysis, or the presence of nephrolithiasis or nephrocalcinosis on x-ray, ultrasound, or CT
  • For patients with PHPT who do not undergo surgery:
    • Monitoring guidelines include at minimum:
      • Obtaining an annual serum calcium
      • DXA every 1 to 2 years
      • Annual estimated glomerular filtration rate (eGFR) / serum creatinine

#Arrangoiz #ParathyroidSurgeon #ParathyroidExpert #Hypercalcemia #PHPT #Hyperparathyroidism #PrimaryHyperparathyroidism #EndocrineSurgery #HeadandNeckSurgeon #CancerSurgeon #Surgeon #Teacher #Miami #Mexico #MountSinaiMedicalCenter #MSMC

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