title: Prospective 10-year study of postmenopausal women with asymptomatic primary hyperparathyroidism.
abstract: OBJECTIVE
  There are few prospective studies of people with asymptomatic primary hyperparathyroidism (PHPT) who have not had parathyroidectomy. We followed a group of postmenopausal women with asymptomatic PHPT for up to 10 years to determine whether they could be managed conservatively without parathyroidectomy.
  
  
  METHODS
  A 10-year, prospective, longitudinal study of 23 postmenopausal women with asymptomatic PHPT initially enrolled into a 4-year randomised controlled trial of hormone replacement therapy. Serum total and ionised calcium, biochemistry, urine calcium, and bone mineral density were measured every 6-12 months.
  
  
  RESULTS
  Serum ionised calcium, creatinine, and urine calcium:creatinine remained stable throughout follow-up. In contrast, there was a steady increase in the total and adjusted serum calcium and a small rise in serum PTH. Only one woman had an adjusted serum calcium >3.0 mmol/L during follow-up. There were few other clinical events possibly related to PHPT (1 possible episode of nephrolithiasis, 4 fractures, 1 severe osteoporosis). Three women underwent parathyroidectomy, although 19/23 women met the updated criteria for parathyroidectomy from the 2002 NIH-sponsored workshop during follow-up.
  
  
  CONCLUSIONS
  Many postmenopausal women with asymptomatic PHPT do not develop symptoms or complications of PHPT, and their biochemical parameters remains stable. Therefore, such asymptomatic women with PHPT can often be managed conservatively without parathyroidectomy.
authors.affiliation: Osteoporosis Research Group, Department of Medicine, University of Auckland, Private Bag 92 019, Auckland 1020, New Zealand. m.bolland@auckland.ac.nz
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Bolland
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Grey
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Orr-Walker
authors.forename: Anne M
authors.initials: AM
authors.lastname: Horne
authors.forename: Margaret C
authors.initials: MC
authors.lastname: Evans
authors.forename: Judy M
authors.initials: JM
authors.lastname: Clearwater
authors.forename: Greg D
authors.initials: GD
authors.lastname: Gamble
authors.forename: Ian R
authors.initials: IR
authors.lastname: Reid
mesh_terms: D000368:Aged; D015519:Bone Density; D002118:Calcium / Q000097:blood / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D007669:Kidney Calculi / Q000209:etiology; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology; D016105:Parathyroidectomy; D017698:Postmenopause; D011446:Prospective Studies
chemical_list: D002118:Calcium