Asymptomatic primary hyperparathyroidism: a surgical perspective.
Since the advent of multichannel autoanalyzers and routine screening of serum calcium levels, prevalence of primary hyperparathyroidism (pHPT) has increased to between 0.1% and 0.4%. As more patients present with "asymptomatic" pHPT, ideal treatment of "mild" disease becomes more controversial, with the possibility of safe, nonoperative management in a selected group of patients. Accumulated evidence confirms that the majority of these patients suffer from vague, nonspecific complaints that are very real and can improve following parathyroidectomy. Furthermore, parathyroidectomy in patients with pHPT has been demonstrated to improve bone mineral density, reduce fracture risk, and improve health-related quality of life and possibly overall survival. Therefore, all patients with primary hyperparathyroidism should be referred for surgical evaluation by an experienced endocrine surgeon.
Mack
Lloyd A
LA
Tom Baker Cancer Centre, University of Calgary, 1331 29th Street NW, Calgary, Alberta, Canada.
Pasieka
Janice L
JL
D001847:Bone Diseases / Q000209:etiology; D018572:Disease-Free Survival; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000523:psychology / Q000601:surgery*; D007674:Kidney Diseases / Q000209:etiology; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D016105:Parathyroidectomy; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome