title: [Clinical and biochemical diagnosis of pHPT and sHPT, surgical indications from the internal medicine viewpoint].
abstract: Hypercalcemia and a relative nonsuppressibility of parathyroid hormone by calcium are the biochemical hallmarks of primary hyperparathyroidism. An elevated PTH level should be defined in a highly sensitive and specific test system. Primary HPT is the single major cause of hypercalcemia in outpatients. A definitive medical option to manage PHP does not exist. Surgical neck exploration by an experienced surgeon has a very high success rate for cure in both symptomatic and asymptomatic disease forms. Secondary HPT is mostly due to renal failure. Nonsuppressibility of PTH by use of vitamin D sterols indicates parathyroid gland hyperplasia and autonomy of PTH secretion. Surgery should correct PTH excess and should lead to an optimal bone status.
authors.affiliation: Sektion Endokrinologie, Universitätsklinikum Ulm, Robert-Koch-Strasse 8, 89081 Ulm/Donau.
authors.forename: B O
authors.initials: BO
authors.lastname: Böhm
mesh_terms: D003131:Combined Modality Therapy; D019091:Critical Pathways; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000601:surgery*; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis / Q000601:surgery*; D016105:Parathyroidectomy; D016896:Treatment Outcome