title: [Referral of patients with parathyroid dysfunction to specialists--which patients should be referred to parathyroidologists?].
abstract: Although a diagnosis of primary hyperparathyroidism and hypothyroidism becomes very easy at the present time due to development of highly sensitive assay for parathyroid hormone, the diagnosis of hyper- and hypothyroidism should be made by excluding the loss and gain of function mutation of calcium sensing receptor, respectively. When a diagnosis of primary hyperparathyroidism is made but the localization of adenoma(s) is not identified, the patient should be referred to specialists for parathyroid surgery. Although patients with primary hypoparathyroidism can be followed by a general physician, they should be referred to specialists when they become pregnant, since active vitamin D is increased and decreased in the late pregnancy and in the postpartum period, respectively.
authors.affiliation: Field of Thyroid and Parathyroid Disease Division of Internal Medicine, Graduate School of Medicine, Tokyo Women's Medical University.
authors.forename: Kanji
authors.initials: K
authors.lastname: Sato
mesh_terms: D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis; D008511:Medicine; D010279:Parathyroid Diseases / Q000175:diagnosis* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D012017:Referral and Consultation; D013038:Specialization