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Subtle Variants of Hyperparathyroidism: Normocalcemic Hyperparathyroidism

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Abstract

Normocalcemic hyperparathyroidism (NCHPT) was recognized as a distinct variant of primary hyperparathyroidism during the Third International Workshop on Asymptomatic Hyperparathyroidism. Normal, albumin-corrected, serum, or ionized calcium levels paired with inappropriately elevated parathyroid hormone (PTH) levels are required to make the diagnosis after secondary causes of hyperparathyroidism are ruled out. The decision to intervene in these patients is often challenging. In asymptomatic patients, close monitoring with annual clinical assessment and biochemical testing is reasonable. When surgery is pursued, a focused parathyroidectomy with the use of intraoperative PTH monitoring can be considered. Critically, a low threshold to convert to a four-gland exploration if strict PTH criteria are not achieved is required.

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Authors and Affiliations

  1. Department of General Surgery, Ochsner Louisiana State University of Health Sciences Center - Shreveport, Shreveport, LA, USA

    Rohit Ranganath

  2. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA

    Kendall F. Moseley

  3. Division of Head and Neck Endocrine Surgery, Department of Otolaryngology – Head and Neck Surgery, The Johns Hopkins School of Medicine; The Johns Hopkins Hospital, Baltimore, MD, USA

    Ralph P. Tufano

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  1. Rohit Ranganath
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  3. Ralph P. Tufano
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Correspondence to Ralph P. Tufano .

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Editors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, Henry Ford Hospital System, Detroit, MI, USA

    Michael C. Singer

  2. Department Otolaryngology and Endocrinology, Augusta University Thyroid and Parathyroid Center, Augusta University, Augusta, GA, USA

    David J. Terris

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Ranganath, R., Moseley, K.F., Tufano, R.P. (2021). Subtle Variants of Hyperparathyroidism: Normocalcemic Hyperparathyroidism. In: Singer, M.C., Terris, D.J. (eds) Innovations in Modern Endocrine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-73951-5_9

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