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Primary Hyperparathyroidism

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Hypercalcemia

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Primary hyperparathyroidism (PHPT) is a disorder of mineral metabolism characterized primarily by hypercalcemia and inappropriate levels of parathyroid hormone (PTH). With the advent of biochemical screening and a more proactive approach to individuals with low bone density, several different phenotypes of the disease have become well recognized. The form fruste of the disease, classical PHPT, with its attendant symptomatic hypercalcemia, osteitis fibrosa cystica, stones, and proximal muscle weakness is infrequently seen in developed countries. More often, asymptomatic hypercalcemia is seen. Evaluation of these individuals, however, reveals evidence for the involvement of the skeleton and the kidneys in many individuals. The normocalcemic variant is also well-recognized, but more information is needed to understand its pathophysiology in relationship to the hypercalcemic form. Parathyroidectomy cures PHPT but not all patients undergo parathyroid surgery. Guidelines have been very helpful to decide who is best advised to undergo parathyroid surgery. Guidelines have also been helpful in the management of those patients who do not undergo parathyroid surgery.

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Acknowledgments

This work was supported in part by National Institutes of Health grants NIDDK 32333.

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  1. Division of Endocrinology, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA

    John P. Bilezikian

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    Marcella Donovan Walker

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Bilezikian, J.P. (2022). Primary Hyperparathyroidism. In: Walker, M.D. (eds) Hypercalcemia. Contemporary Endocrinology. Humana, Cham. https://doi.org/10.1007/978-3-030-93182-7_6

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