Diagnosis of asymptomatic primary hyperparathyroidism: Proceedings of the third international workshop

Richard Eastell, A. Arnold, M. L. Brandi, E. M. Brown, P. D'Amour, D. A. Hanley, D. Sudhaker Rao, M. R. Rubin, D. Goltzman, S. J. Silverberg, S. J. Marx, M. Peacock, L. Mosekilde, R. Bouillon, E. M. Lewiecki

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Abstract

Objective: Asymptomatic primary hyperparathyroidism (PHPT) is a common clinical problem. The purpose of this report is to guide the use of diagnostic tests for this condition in clinical practice. Participants: Interested professional societies selected a representative for the consensus committee and provided funding for a one-day meeting. A subgroup of this committee set the program and developed key questions for review. Consensus was established at a closed meeting that followed. The conclusions were then circulated to the participating professional societies. Evidence: Each question was addressed by a relevant literature search (on PubMed), and the data were presented for discussion at the group meeting. Consensus Process: Consensus was achieved by a group meeting. Statements were prepared by all authors, with comments relating to accuracy from the diagnosis subgroup and by representatives from the participating professional societies. Conclusions: We conclude that: 1) reference ranges should be established for serum PTH in vitamin D-replete healthy individuals; 2) second- and third-generation PTH assays are both helpful in the diagnosis of PHPT; 3) DNA sequence testing can be useful in familial hyperparathyroidism or hypercalcemia; 4) normocalcemic PHPT is a variant of the more common presentation of PHPT with hypercalcemia; 5) serum 25-hydroxyvitamin D levels should be measured and, if vitamin D insufficiency is present, it should be treated as part of any management course; and 6) the estimated glomerular filtration rate should be used to determine the level of kidney function in PHPT: an estimated glomerular filtration rate of less than 60 ml/min·1.73 m2 should be a benchmark for decisions about surgery in established asymptomatic PHPT.

Original languageEnglish (US)
Pages (from-to)340-350
Number of pages11
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number2
DOIs
StatePublished - Feb 2009

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ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Eastell, R., Arnold, A., Brandi, M. L., Brown, E. M., D'Amour, P., Hanley, D. A., Sudhaker Rao, D., Rubin, M. R., Goltzman, D., Silverberg, S. J., Marx, S. J., Peacock, M., Mosekilde, L., Bouillon, R., & Lewiecki, E. M. (2009). Diagnosis of asymptomatic primary hyperparathyroidism: Proceedings of the third international workshop. Journal of Clinical Endocrinology and Metabolism, 94(2), 340-350. https://doi.org/10.1210/jc.2008-1758