Diagnosis of Asymptomatic Primary Hyperparathyroidism: Proceedings of the Fourth International Workshop

• Autor(a) principal: Eastell, Richard
• Data de Publicação: 2014
• Outros Autores: Brandi, Maria Luisa, Costa, Aline G. [UNIFESP], D'Amour, Pierre, Shoback, Dolores M., Thakker, Rajesh V.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1210/jc.2014-1414; http://repositorio.unifesp.br/handle/11600/38251

Objective: Asymptomatic primary hyperparathyroidism (PHPT) is a common clinical problem. the purpose of this report is to provide an update on the use of diagnostic tests for this condition in clinical practice.Participants: This subgroup was constituted by the Steering Committee to address key questions related to the diagnosis of PHPT. Consensus was established at a closed meeting of the Expert Panel that followed.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) normocalcemic PHPT is a variant of the more common presentation of PHPT with hypercalcemia; 4) serum 25-hydroxyvitamin D concentrations should be measured and, if vitamin D insufficiency is present, it should be treated as part of any management course; 5) genetic testing has the potential to be useful in the differential diagnosis of familial hyperparathyroidism or hypercalcemia.