Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus

A. A. Khan, D. A. Hanley, R. Rizzoli, J. Bollerslev, J. E.M. Young, L. Rejnmark, R. Thakker, P. D’Amour, T. Paul, S. Van Uum, M. Zakaria Shrayyef, D. Goltzman, S. Kaiser, N. E. Cusano, R. Bouillon, L. Mosekilde, A. W. Kung, S. D. Rao, S. K. Bhadada, Bart ClarkeJ. Liu, Q. Duh, E. Michael Lewiecki, F. Bandeira, R. Eastell, C. Marcocci, S. J. Silverberg, R. Udelsman, K. Shawn Davison, J. T. Potts, M. L. Brandi, J. P. Bilezikian

Research output: Contribution to journalReview article

85 Citations (Scopus)

Abstract

The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.

Original languageEnglish (US)
JournalOsteoporosis International
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Primary Hyperparathyroidism
Nephrolithiasis
Parathyroidectomy
Hyperparathyroidism
Hypercalcemia
Parathyroid Hormone
Skeleton
Guidelines
Therapeutics

Keywords

  • Diagnosis
  • Management
  • Osteoporosis
  • Primary hyperparathyroidism
  • Surgery
  • Treatment

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Primary hyperparathyroidism : review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. / Khan, A. A.; Hanley, D. A.; Rizzoli, R.; Bollerslev, J.; Young, J. E.M.; Rejnmark, L.; Thakker, R.; D’Amour, P.; Paul, T.; Van Uum, S.; Shrayyef, M. Zakaria; Goltzman, D.; Kaiser, S.; Cusano, N. E.; Bouillon, R.; Mosekilde, L.; Kung, A. W.; Rao, S. D.; Bhadada, S. K.; Clarke, Bart; Liu, J.; Duh, Q.; Lewiecki, E. Michael; Bandeira, F.; Eastell, R.; Marcocci, C.; Silverberg, S. J.; Udelsman, R.; Davison, K. Shawn; Potts, J. T.; Brandi, M. L.; Bilezikian, J. P.

In: Osteoporosis International, Vol. 28, No. 1, 01.01.2017.

Research output: Contribution to journalReview article

Khan, AA, Hanley, DA, Rizzoli, R, Bollerslev, J, Young, JEM, Rejnmark, L, Thakker, R, D’Amour, P, Paul, T, Van Uum, S, Shrayyef, MZ, Goltzman, D, Kaiser, S, Cusano, NE, Bouillon, R, Mosekilde, L, Kung, AW, Rao, SD, Bhadada, SK, Clarke, B, Liu, J, Duh, Q, Lewiecki, EM, Bandeira, F, Eastell, R, Marcocci, C, Silverberg, SJ, Udelsman, R, Davison, KS, Potts, JT, Brandi, ML & Bilezikian, JP 2017, 'Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus', Osteoporosis International, vol. 28, no. 1. https://doi.org/10.1007/s00198-016-3716-2
Khan, A. A. ; Hanley, D. A. ; Rizzoli, R. ; Bollerslev, J. ; Young, J. E.M. ; Rejnmark, L. ; Thakker, R. ; D’Amour, P. ; Paul, T. ; Van Uum, S. ; Shrayyef, M. Zakaria ; Goltzman, D. ; Kaiser, S. ; Cusano, N. E. ; Bouillon, R. ; Mosekilde, L. ; Kung, A. W. ; Rao, S. D. ; Bhadada, S. K. ; Clarke, Bart ; Liu, J. ; Duh, Q. ; Lewiecki, E. Michael ; Bandeira, F. ; Eastell, R. ; Marcocci, C. ; Silverberg, S. J. ; Udelsman, R. ; Davison, K. Shawn ; Potts, J. T. ; Brandi, M. L. ; Bilezikian, J. P. / Primary hyperparathyroidism : review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. In: Osteoporosis International. 2017 ; Vol. 28, No. 1.
@article{af517d7558e64872837647257dbfc3eb,
title = "Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus",
abstract = "The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of {"}Hyperparathyroidism. Primary{"} was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.",
keywords = "Diagnosis, Management, Osteoporosis, Primary hyperparathyroidism, Surgery, Treatment",
author = "Khan, {A. A.} and Hanley, {D. A.} and R. Rizzoli and J. Bollerslev and Young, {J. E.M.} and L. Rejnmark and R. Thakker and P. D’Amour and T. Paul and {Van Uum}, S. and Shrayyef, {M. Zakaria} and D. Goltzman and S. Kaiser and Cusano, {N. E.} and R. Bouillon and L. Mosekilde and Kung, {A. W.} and Rao, {S. D.} and Bhadada, {S. K.} and Bart Clarke and J. Liu and Q. Duh and Lewiecki, {E. Michael} and F. Bandeira and R. Eastell and C. Marcocci and Silverberg, {S. J.} and R. Udelsman and Davison, {K. Shawn} and Potts, {J. T.} and Brandi, {M. L.} and Bilezikian, {J. P.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1007/s00198-016-3716-2",
language = "English (US)",
volume = "28",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "1",

}

TY - JOUR

T1 - Primary hyperparathyroidism

T2 - review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus

AU - Khan, A. A.

AU - Hanley, D. A.

AU - Rizzoli, R.

AU - Bollerslev, J.

AU - Young, J. E.M.

AU - Rejnmark, L.

AU - Thakker, R.

AU - D’Amour, P.

AU - Paul, T.

AU - Van Uum, S.

AU - Shrayyef, M. Zakaria

AU - Goltzman, D.

AU - Kaiser, S.

AU - Cusano, N. E.

AU - Bouillon, R.

AU - Mosekilde, L.

AU - Kung, A. W.

AU - Rao, S. D.

AU - Bhadada, S. K.

AU - Clarke, Bart

AU - Liu, J.

AU - Duh, Q.

AU - Lewiecki, E. Michael

AU - Bandeira, F.

AU - Eastell, R.

AU - Marcocci, C.

AU - Silverberg, S. J.

AU - Udelsman, R.

AU - Davison, K. Shawn

AU - Potts, J. T.

AU - Brandi, M. L.

AU - Bilezikian, J. P.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.

AB - The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of "Hyperparathyroidism. Primary" was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.

KW - Diagnosis

KW - Management

KW - Osteoporosis

KW - Primary hyperparathyroidism

KW - Surgery

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=84986269240&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84986269240&partnerID=8YFLogxK

U2 - 10.1007/s00198-016-3716-2

DO - 10.1007/s00198-016-3716-2

M3 - Review article

C2 - 27613721

AN - SCOPUS:84986269240

VL - 28

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

IS - 1

ER -