Clinical Presentation of Primary Hyperparathyroidism

Bandeira, Francisco; Correia, Aline

doi:10.1016/b978-0-12-397166-1.00020-5

Cited by 17 publications

(13 citation statements)

References 99 publications

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“…Where biochemical screening is routinely performed, PHPT usually presents with mild hypercalcemia. Overt bone and stone diseases are unusual 15 . A good illustration of how the availability of biochemical screening can influence the clinical presentation of PHPT is seen in the study comparing PHPT in the US and China.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Although the trend for asymptomatic PHPT to become progressively more the dominant form of PHPT is clear worldwide, symptomatic PHPT continues to be the predominant form of the disease in some countries, such as India, Iran, and Saudi Arabia 15 .…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Within a decade, albeit in different cities, the incidence of asymptomatic PHPT increased from 34% in São Paulo to 82% in Recife 7 , 8 . Data from other Latin American countries are limited, but it seems that the majority of patients still present with symptomatic PHPT 15 .…”

Section: Clinical Presentationmentioning

confidence: 99%

“…PHPT can affect organs other than the skeleton and kidney when it presents as a symptomatic disease. Other affected organ systems include the neuromuscular (peripheral polyneuropathy and proximal muscle weakness), gastrointestinal tract (peptic ulcer and pancreatitis), cardiovascular (hypertension, atherosclerosis, left ventricular hypertrophy, valve calcification, and arrhythmias), and psychiatric (anxiety, irritability, apathy, psychosis, and loss of memory) disorders 15 , 18 , 19 . Also, manifestations related to symptomatic hypercalcemia can be present; these include nausea, vomiting, constipation, polyuria, polydipsia, mental confusion, coma, and a short QT interval on the electrocardiogram 20 .…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Owing to the prevalence of asymptomatic PHPT, OFC is rarely seen these days in developed countries. However, skeletal involvement continues to be readily detected by technologies such as DXA 15 , 21 . Reduced BMD is observed most often in distal 1/3 radius site, comprised mostly of cortical bone, with relative preservation of lumbar spine, a site that is endowed primarily with trabecular bone 22 .…”

Section: Clinical Presentationmentioning

confidence: 99%

See 4 more Smart Citations

Primary Hyperparathyroidism

Bandeira

Bilezikian

2016

F1000Res

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Over the past several generations, primary hyperparathyroidism (PHTP) has undergone a change in its clinical presentation in many countries from a symptomatic disease to an asymptomatic one. The reasons for this change in clinical presentation are related to the widespread use of biochemical screening tests, to the measurement of PTH more routinely in the evaluation of metabolic bone disease and to the status of vitamin D sufficiency in the population. Along with recognition of a broader clinical spectrum of disease, including a more recently recognized normocalcemic variant, has come an appreciation that the evaluation of classic target organs that can be affected in PHPT, such as the skeleton and the kidneys, require more advanced imaging technology for complete evaluation. It is clear that even in asymptomatic patients, evidence for microstructural disease in the skeleton and calcifications in the kidneys can be demonstrated often. Potential non-classical manifestations of PHPT related to neurocognition and the cardiovascular system continue to be of interest. As a result of these advances, revised guidelines for the management of asymptomatic PHPT have been recently published to help the clinician determine whether surgery is appropriate or whether a more conservative approach is acceptable.

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Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%