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Primary Hyperparathyroidism: Diagnosis and Workup

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Surgical Endocrinopathies

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Abstract

The diagnosis of primary hyperparathyroidism (PHPT) is made by demonstrating simultaneous elevation of serum calcium and parathyroid hormone (PTH) levels in a patient who does not have hypocalciuria. Over the past decade, it has also been recognized that there is a normocalcemic variant of PHPT where the serum calcium level is normal, but usually at the upper end of the normal range, and the serum PTH is either elevated or inappropriately high. A normohormonal variant of PHPT is also now recognized, where hypercalcemia is accompanied by inappropriately high PTH that is still within the normal reference range. Elderly patients are the least likely to be referred for parathyroid surgery. As the US population ages, appropriate use of parathyroidectomy may play an important role in increasing health-care value by reducing costly negative health events of hyperparathyroidism such as fragility fracture and kidney stone formation. Most parathyroid surgeons believe that hyperparathyroidism is under-recognized, underreported, and undertreated.

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Authors and Affiliations

  1. Endocrine Surgery, Northwestern University, 676 North Saint Clair St., Suite 650, 60611, Chicago, IL, USA

    Cord Sturgeon MD, MS

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  1. Cord Sturgeon MD, MS
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Correspondence to Cord Sturgeon MD, MS .

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Editors and Affiliations

  1. Divisions of General Surgery and Surgical Oncology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada

    Janice L. Pasieka

  2. Department of Surgery, Columbia University Medical Center, New York, New York, USA

    James A. Lee

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Sturgeon, C. (2015). Primary Hyperparathyroidism: Diagnosis and Workup. In: Pasieka, J., Lee, J. (eds) Surgical Endocrinopathies. Springer, Cham. https://doi.org/10.1007/978-3-319-13662-2_20

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  • DOI: https://doi.org/10.1007/978-3-319-13662-2_20

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  • Publisher Name: Springer, Cham

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