2013
DOI: 10.1590/s0004-27302013000600002
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Abstract: Objective: To conduct a literature review on the diagnosis and management of primary hyperparathyroidism including the classical hipercalcemic form as well as the normocalcemic variant. Materials and methods: This scientific statement was generated by a request from the Brazilian Medical Association (AMB) to the Brazilian Society for Endocrinology as part of its Clinical Practice Guidelines program. Articles were identified by searching in PubMed and Cochrane databases as well as abstracts presented at the End… Show more

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Cited by 59 publications
(74 citation statements)
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References 142 publications
(98 reference statements)
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“…Over the past decades, the disease has shown a change in presentation at diagnosis, from very symptomatic to oligo-or asymptomatic, even in developing countries (13,18). These patients, who present with mild primary hyperparathyroidism, are less likely to show abnormal laboratory findings at diagnosis, and present serum calcium and PTH measurements not as elevated as patients with overt symptoms of the disease (19).…”
Section: Discussionmentioning
confidence: 99%
“…Over the past decades, the disease has shown a change in presentation at diagnosis, from very symptomatic to oligo-or asymptomatic, even in developing countries (13,18). These patients, who present with mild primary hyperparathyroidism, are less likely to show abnormal laboratory findings at diagnosis, and present serum calcium and PTH measurements not as elevated as patients with overt symptoms of the disease (19).…”
Section: Discussionmentioning
confidence: 99%
“…The Tc-99-Sestamibi scan was less sensitive, failing to localize either adenoma. The sensitivity of ultrasound is highly operator-dependent, but its accuracy may be as high as 88% in asymptomatic hypercalcemic patients (10). When it detects intra-thyroid nodules, FNA with measurement of PTH in the aspiration fluid is very useful as thyroid nodules may cause false-positive Sestamibi scan results (11).…”
Section: Discussionmentioning
confidence: 99%
“…The most common clinical presentation of PHPT is asymptomatic hypercalcemia with an elevated or high-or normal intact PTH level. Patients with hypercalcemia may present with vague constitutional symptoms, anorexia, lethargy, or polydipsia and polyuria [7][8][9]. Less specific features of PHPT are fatigue, proximal muscle weakness, mild cognitive disturbances, hypertension, left ventricular hypertrophy, valvular calcification, and cardiovascular mortality [2,10].…”
mentioning
confidence: 99%
“…If PHPT due to a parathyroid adenoma (or adenomas), parathyroidectomy is the definitive cure. Surgery has a very high long-term success rate and minimal morbidity [7,8]. Medical therapy, such as calcimimetics, may gain popularity for patients with hypercalcemia who can not undergo surgery.…”
mentioning
confidence: 99%