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Single-Gland Primary Hyperparathyroidism: Classic and Early Disease

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Medical and Surgical Treatment of Parathyroid Diseases

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Abstract

Primary hyperparathyroidism (PHPT) is an asymptomatic PTH-dependent hypercalcemia typically from a single gland adenoma, with variable risks for kidney stones and declining bone mass. Subtleties exist in diagnosing and differentiating PHPT from other forms of PTH-dependent hypercalcemia. Therapeutic intervention manages the short and long term complications including hypercalcemia, bone loss and fracture risks, renal function decline, and kidney stones. Careful attention to biochemical diagnosis followed by appropriate imaging establishes the diagnosis in most patients. Some studies now suggest a threshold for monitored patients where there is an increase in pathologic events raising the question should all correctly identified single-gland hyperparathyroidism patients undergo surgery at the time of diagnosis? Continued discussion and review of consensus guidelines provide a framework for care of these patients and framing future work to resolve these questions in what can be a slowly progressive but significantly detrimental disease.

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  1. Department of Otolaryngology and Division of Endocrinology, Oregon Health and Science University, 3181 Sw Sam Jackson Park Rd, Portland, OR, 97239, USA

    Dana L. Madison M.D., Ph.D.

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Correspondence to Dana L. Madison M.D., Ph.D. .

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  1. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Brendan C. Stack, Jr.

  2. Department of Geniatrics and Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Donald L. Bodenner

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Madison, D.L. (2017). Single-Gland Primary Hyperparathyroidism: Classic and Early Disease. In: Stack, Jr., B., Bodenner, D. (eds) Medical and Surgical Treatment of Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26794-4_5

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