Presentation of asymptomatic primary hyperparathyroidism: Proceedings of the Third International Workshop

Shonni J. Silverberg, E. Michael Lewiecki, Leif Mosekilde, Munro Peacock, Mishaela R. Rubin

Research output: Contribution to journalArticle

231 Citations (Scopus)

Abstract

Background: At the Third International Workshop on Asymptomatic Primary Hyperparathyroidism (PHPT) in May 2008, recent data on the disease were reviewed. We present the results of a literature review on issues arising from the clinical presentation and natural history of PHPT. Methods: Questions were developed by the International Task Force on PHPT. A comprehensive literature search for relevant studies was reviewed, and the questions of the International Task Force were addressed by the Consensus Panel. Conclusions: 1) Data on the extent and nature of cardiovascular involvement in those with mild disease are too limited to provide a complete picture. 2) Patients with mild PHPT have neuropsychological complaints. Although some symptoms may improve with surgery, available data remain inconsistent on their precise nature and reversibility. 3) Surgery leads to long-term gains in spine, hip, and radius bone mineral density (BMD). Because some patients have early disease progression and others lose BMD after 8-10 yr, regular monitoring (serum calcium and three-site BMD) is essential in those followed without surgery. Patients may present with normocalcemic PHPT (normal serum calcium with elevated PTH concentrations; no secondary cause for hyperparathyroidism). Data on the incidence and natural history of this phenotype are limited. 4) In the absence of kidney stones, data do not support the use of marked hypercalciuria (>10 mmol/d or 400 mg/d) as an indication for surgery for patients. 5) Patients with bone density T-score -2.5 or less at the lumbar spine, hip, or distal one third radius should have surgery.

Original languageEnglish
Pages (from-to)351-365
Number of pages15
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number2
DOIs
StatePublished - Feb 2009

Fingerprint

Primary Hyperparathyroidism
Surgery
Bone Density
Bone
Education
Minerals
Advisory Committees
Spine
Pelvic Bones
Calcium
Hypercalciuria
Secondary Hyperparathyroidism
Kidney Calculi
Natural History
Serum
Disease Progression
Hip
Phenotype
Monitoring
Incidence

ASJC Scopus subject areas

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

Cite this

Presentation of asymptomatic primary hyperparathyroidism : Proceedings of the Third International Workshop. / Silverberg, Shonni J.; Lewiecki, E. Michael; Mosekilde, Leif; Peacock, Munro; Rubin, Mishaela R.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 94, No. 2, 02.2009, p. 351-365.

Research output: Contribution to journalArticle

Silverberg, Shonni J. ; Lewiecki, E. Michael ; Mosekilde, Leif ; Peacock, Munro ; Rubin, Mishaela R. / Presentation of asymptomatic primary hyperparathyroidism : Proceedings of the Third International Workshop. In: Journal of Clinical Endocrinology and Metabolism. 2009 ; Vol. 94, No. 2. pp. 351-365.
@article{9477a5377df64dbd9385b8d13129da69,
title = "Presentation of asymptomatic primary hyperparathyroidism: Proceedings of the Third International Workshop",
abstract = "Background: At the Third International Workshop on Asymptomatic Primary Hyperparathyroidism (PHPT) in May 2008, recent data on the disease were reviewed. We present the results of a literature review on issues arising from the clinical presentation and natural history of PHPT. Methods: Questions were developed by the International Task Force on PHPT. A comprehensive literature search for relevant studies was reviewed, and the questions of the International Task Force were addressed by the Consensus Panel. Conclusions: 1) Data on the extent and nature of cardiovascular involvement in those with mild disease are too limited to provide a complete picture. 2) Patients with mild PHPT have neuropsychological complaints. Although some symptoms may improve with surgery, available data remain inconsistent on their precise nature and reversibility. 3) Surgery leads to long-term gains in spine, hip, and radius bone mineral density (BMD). Because some patients have early disease progression and others lose BMD after 8-10 yr, regular monitoring (serum calcium and three-site BMD) is essential in those followed without surgery. Patients may present with normocalcemic PHPT (normal serum calcium with elevated PTH concentrations; no secondary cause for hyperparathyroidism). Data on the incidence and natural history of this phenotype are limited. 4) In the absence of kidney stones, data do not support the use of marked hypercalciuria (>10 mmol/d or 400 mg/d) as an indication for surgery for patients. 5) Patients with bone density T-score -2.5 or less at the lumbar spine, hip, or distal one third radius should have surgery.",
author = "Silverberg, {Shonni J.} and Lewiecki, {E. Michael} and Leif Mosekilde and Munro Peacock and Rubin, {Mishaela R.}",
year = "2009",
month = "2",
doi = "10.1210/jc.2008-1760",
language = "English",
volume = "94",
pages = "351--365",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "2",

}

TY - JOUR

T1 - Presentation of asymptomatic primary hyperparathyroidism

T2 - Proceedings of the Third International Workshop

AU - Silverberg, Shonni J.

AU - Lewiecki, E. Michael

AU - Mosekilde, Leif

AU - Peacock, Munro

AU - Rubin, Mishaela R.

PY - 2009/2

Y1 - 2009/2

N2 - Background: At the Third International Workshop on Asymptomatic Primary Hyperparathyroidism (PHPT) in May 2008, recent data on the disease were reviewed. We present the results of a literature review on issues arising from the clinical presentation and natural history of PHPT. Methods: Questions were developed by the International Task Force on PHPT. A comprehensive literature search for relevant studies was reviewed, and the questions of the International Task Force were addressed by the Consensus Panel. Conclusions: 1) Data on the extent and nature of cardiovascular involvement in those with mild disease are too limited to provide a complete picture. 2) Patients with mild PHPT have neuropsychological complaints. Although some symptoms may improve with surgery, available data remain inconsistent on their precise nature and reversibility. 3) Surgery leads to long-term gains in spine, hip, and radius bone mineral density (BMD). Because some patients have early disease progression and others lose BMD after 8-10 yr, regular monitoring (serum calcium and three-site BMD) is essential in those followed without surgery. Patients may present with normocalcemic PHPT (normal serum calcium with elevated PTH concentrations; no secondary cause for hyperparathyroidism). Data on the incidence and natural history of this phenotype are limited. 4) In the absence of kidney stones, data do not support the use of marked hypercalciuria (>10 mmol/d or 400 mg/d) as an indication for surgery for patients. 5) Patients with bone density T-score -2.5 or less at the lumbar spine, hip, or distal one third radius should have surgery.

AB - Background: At the Third International Workshop on Asymptomatic Primary Hyperparathyroidism (PHPT) in May 2008, recent data on the disease were reviewed. We present the results of a literature review on issues arising from the clinical presentation and natural history of PHPT. Methods: Questions were developed by the International Task Force on PHPT. A comprehensive literature search for relevant studies was reviewed, and the questions of the International Task Force were addressed by the Consensus Panel. Conclusions: 1) Data on the extent and nature of cardiovascular involvement in those with mild disease are too limited to provide a complete picture. 2) Patients with mild PHPT have neuropsychological complaints. Although some symptoms may improve with surgery, available data remain inconsistent on their precise nature and reversibility. 3) Surgery leads to long-term gains in spine, hip, and radius bone mineral density (BMD). Because some patients have early disease progression and others lose BMD after 8-10 yr, regular monitoring (serum calcium and three-site BMD) is essential in those followed without surgery. Patients may present with normocalcemic PHPT (normal serum calcium with elevated PTH concentrations; no secondary cause for hyperparathyroidism). Data on the incidence and natural history of this phenotype are limited. 4) In the absence of kidney stones, data do not support the use of marked hypercalciuria (>10 mmol/d or 400 mg/d) as an indication for surgery for patients. 5) Patients with bone density T-score -2.5 or less at the lumbar spine, hip, or distal one third radius should have surgery.

UR - http://www.scopus.com/inward/record.url?scp=59749099024&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=59749099024&partnerID=8YFLogxK

U2 - 10.1210/jc.2008-1760

DO - 10.1210/jc.2008-1760

M3 - Article

C2 - 19193910

AN - SCOPUS:59749099024

VL - 94

SP - 351

EP - 365

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 2

ER -