Response to Letter to the Editor: “Normocalcemic Hyperparathyroidism: Study of its Prevalence and Natural History”

Schini, Marian; Eastell, Richard

doi:10.1210/clinem/dgaa278

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Further debate regarding the diagnosis of NHPT was generated in 2020 with publication of the manuscript by Schini et al [ 10 ] from the University of Sheffield (UK) [ 11 , 12 ]. After observing that serum calcium levels oscillate with time, and sporadically exceed the upper limit of the normal range, raising the likelihood of classical PHPT, these authors proposed a new approach to defining NHPT [ 13 ] that makes use of the least significant change (LSC) of albumin-adjusted serum calcium.…”

Section: Introductionmentioning

confidence: 99%

Normocalcemic Primary Hyperparathyroidism: Need for a Standardized Clinical Approach

Zavatta

Clarke

2021

Endocrinol Metab

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Since normocalcemic primary hyperparathyroidism (NHPT) was first defined at the Third International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism in 2008, many papers have been published describing its prevalence and possible complications. Guidelines for the management of this condition are still lacking, and making the diagnosis requires fulfillment of strict criteria. Recent studies have shown that intermittent oscillations of serum calcium just below and slightly above the normal limits are very frequent, therefore challenging the assumption that serum calcium must be consistently normal to make the diagnosis. There is debate if these variations in serum calcium outside the normal range should be included under the rubric of NHPT or, rather, a milder form of classical primary hyperparathyroidism. Innovative approaches to define NHPT have been proposed that still need to be validated in prospective studies. Non-classical complications, especially cardiovascular complications, have been associated with NHPT, indicating that hyperparathyroidism may be a cardiovascular risk factor. New associations between parathyroid hormone (PTH) and several other comorbidities have also been reported from observational studies, suggesting that excessive PTH secretion might cause tissue dysfunction independent of serum calcium. Heterogeneous studies using different definitions of NHPT, however, make it difficult to draw definitive conclusions regarding the role of PTH excess when complications other than osteoporosis or kidney stones are described. This review will focus on clinical aspects and suggest an approach to NHPT.

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Section: Introductionmentioning

confidence: 99%

Normocalcemic Primary Hyperparathyroidism: Need for a Standardized Clinical Approach

Zavatta

Clarke

2021

Endocrinol Metab

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Заболевания Щитовидной И Паращитовидной Желез В Условиях Пандемии COVID-19

Лущик¹,

Романовский²,

Данилова³

2020

Рецепт

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Рационализация диагностических протоколов при заболеваниях щитовидной и паращитовидной желез в условиях COVID-19 оговорена международными рекомендациями 2020 г. Ведение пациентов с иммунным и неиммунным тиреотоксикозом и COVID-19 имеет ряд особенностей. На фоне высокой заболеваемости COVID-19 основным источником выявления новых случаев узловых образований щитовидной железы будут результаты КТ у пациентов с нарушениями дыхания или пневмонией. Большинство объемных новообразований являются доброкачественными, и даже при обнаружении злокачественного новообразования щитовидной железы проблема проведения отсроченного хирургического лечения через несколько месяцев не представляет особого риска для жизни. Тонкоигольные аспирационные биопсии (TAБ) щитовидной железы и операции у пациентов с подозрением на COVID-19 могут быть безопасно отложены до клинического выздоровления. The rationalization of diagnostic protocols for diseases of the thyroid and parathyroid glands under the conditions of COVID-19 is stipulated by international recommendations of 2020. The management of patients with immune and non-immune thyrotoxicosis and COVID-19 has a number of features.In the background of high incidence of COVID-19, the main source of detecting new cases of thyroid nodules will be the results of CT scans in patients with respiratory disorders or pneumonia as well as other methods of visualization of the organs of the chest and the neck. Due to the fact that the majority of volumetric neoplasms are benign, and even if a malignant thyroid neoplasm is detected, the issue of performing delayed surgical treatment after a few months does not pose a particular risk for predicting the patient’s life. Thyroid fine needle biopsy (FNB) and surgery in patients with suspected COVID-19 can be safely delayed until clinical recovery.

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Response to Letter to the Editor: “Normocalcemic Hyperparathyroidism: Study of its Prevalence and Natural History”

Cited by 2 publications

References 6 publications

Normocalcemic Primary Hyperparathyroidism: Need for a Standardized Clinical Approach

Normocalcemic Primary Hyperparathyroidism: Need for a Standardized Clinical Approach

Заболевания Щитовидной И Паращитовидной Желез В Условиях Пандемии COVID-19

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