The prevalence of undiagnosed and unrecognized primary hyperparathyroidism: A population-based analysis from the electronic medical record

Press, Danielle; Siperstein, Allan; Berber, Eren; Shin, Joyce; Metzger, Rosemarie; Jin, Judy; Monteiro, Rosebel; Mino, Jeffrey; Swagel, Warren; Mitchell, Jamie

doi:10.1016/j.surg.2013.06.051

Cited by 161 publications

(109 citation statements)

References 12 publications

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“…(1, 2) It is classically characterized by high levels of both serum calcium and parathyroid hormone (PTH). The most common underlying pathology causing primary hyperparathyroidism is a single parathyroid adenoma, but involvement of more than one gland either in the form of multiple adenomas or four-gland hyperplasia occurs not infrequently.…”

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confidence: 99%

CaPTHUS Scoring Model in Primary Hyperparathyroidism: Can It Eliminate the Need for ioPTH Testing?

et al. 2014

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Background The CaPTHUS model was reported to have a positive predictive value (PPV) of 100% to correctly predict single-gland disease in patients with primary hyperparathyroidism, thus obviating the need for ioPTH. We sought to apply the CaPTHUS scoring model in our patient population, and also its utility in predicting long-term biochemical cure. Methods Retrospective review of all parathyroidectomies for primary hyperparathyroidism performed at our university hospital from 2003–2012. We routinely perform ioPTH testing. Biochemical cure was defined as a normal calcium level at 6 months. Results 1421 patients met inclusion criteria: 78% of patients had a single adenoma at the time of surgery, 98% of patients had a normal serum calcium at 1 week postoperatively, and 96% of patients had a normal serum calcium level 6 months postoperatively. Using the previously described CaPTHUS scoring model, 307 (22.5%) patients had a score≥3, with a PPV of 91% for single adenoma. A CaPTHUS score≥3 had a PPV of 98% for biochemical cure at 1 week as well as at 6 months. Conclusions In our population where iOPTH is used routinely to guide use of bilateral exploration, patients with a pre-operative CaPTHUS score≥3 had good long-term biochemical cure rates. However, the model only predicted adenoma in 91% of cases. If MIP without ioPTH had been done for these patients, the cure rate would have dropped from 98% to an unacceptable 89%. Even in these patients with high CaPTHUS scores, multigland disease is present in almost 10% and ioPTH is necessary.

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confidence: 99%

CaPTHUS Scoring Model in Primary Hyperparathyroidism: Can It Eliminate the Need for ioPTH Testing?

et al. 2014

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“…At that time, unexpected high S-calcium values on serum biochemical screening contributed to the diagnosis of 250 new cases of PHPT per million inhabitants per year 24 . Then, the disappearance of the multichannel analyzers and simultaneous introduction of random access analyzers, that in general would benefit the appropriate laboratory test requesting by demanding and measuring only those tests related to a certain diagnosis, resulted in S-calcium under requesting and, hence, a decreased detection of asymptomatic PHPT 25,26 . PHPT became a not so infrequent disease that was often overlooked by physicians 27 .…”

Section: Discussionmentioning

confidence: 99%

Requests of laboratory tests for the diagnosis and management of calcium-phosphate disorders in Spain

et al. 2016

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“…Undiagnosed primary hyperparathyroidism should be rare in this population. For example, Press and colleagues analyzed the medical records of 2.7 million patients at a tertiary referral center and found a prevalence of hypercalcemia (unadjusted total calcium > 10.5 mg/dL) among women of < 2% (31). In practice, primary hyperparathyroidism can be ruled out by a serum PTH that is not elevated (32).…”

Section: Discussionmentioning

confidence: 99%

Serum Calcium and Serum Albumin Are Biomarkers That Can Discriminate Malignant from Benign Pelvic Masses

Kelly

Winkler

Lentz

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Biomarkers that aid in the differential diagnosis of malignant pelvic masses from benign ones prior to surgery are needed in order to triage women with malignant masses to appropriate specialist care. Because high albumin-adjusted serum calcium predicted ovarian cancer among women without evidence of disease, we hypothesized that it might predict cancer among women with pelvic masses that were evident radiographically.Methods: We studied a cohort of 514 women with pelvic masses who underwent resection at Wake Forest University Baptist Medical Center from July 2009 through June 2013. We divided patients into a "training" set, to identify associations in the data, and a "testing" set, to confirm them. Data were obtained from medical records. A best fit model was selected using the Akaike Information Criterion.Results: Albumin-adjusted serum calcium was significantly higher in women with malignant versus benign masses

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The prevalence of undiagnosed and unrecognized primary hyperparathyroidism: A population-based analysis from the electronic medical record

Cited by 161 publications

References 12 publications

CaPTHUS Scoring Model in Primary Hyperparathyroidism: Can It Eliminate the Need for ioPTH Testing?

CaPTHUS Scoring Model in Primary Hyperparathyroidism: Can It Eliminate the Need for ioPTH Testing?

Requests of laboratory tests for the diagnosis and management of calcium-phosphate disorders in Spain

Serum Calcium and Serum Albumin Are Biomarkers That Can Discriminate Malignant from Benign Pelvic Masses

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