Primary hyperparathyroidism--is mild disease worth treating?
Most patients with primary hyperparathyroidism (PHPT) are asymptomatic at presentation. This presents the dilemma whether to treat surgically or manage by conservative follow-up. This article covers the risks of managing mild PHPT conservatively. Some of these risks are well established, for example worsening of bone disease and increased risk of nephrolithiasis. Others, such as effects on cardiovascular function or the risk of malignancy are more controversial. These factors are critical to decisions relating to surgical or conservative management of mild PHPT.
Gittoes
N J L
NJ
Department of Endocrinology, Queen Elizabeth Hospital Birmingham, Edgbaston. Neil.Gittoes@uhb.nhs.uk
Cooper
M S
MS
D001847:Bone Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016105:Parathyroidectomy; D012307:Risk Factors
J Clin Endocrinol Metab. 2004 Jul;89(7):3319-25
15240609
J Intern Med. 1991 Jul;230(1):29-35
2066709
Am J Surg. 1973 Oct;126(4):539-43
4743840
Ann Surg. 2002 May;235(5):665-70; discussion 670-2
11981212
Surgery. 2002 Dec;132(6):1126-32; discussion 1132
12490865
J Clin Endocrinol Metab. 2009 Feb;94(2):373-81
19193912
J Clin Endocrinol Metab. 2005 Jan;90(1):135-41
15522938
J Clin Endocrinol Metab. 2004 Nov;89(11):5415-22
15531491
Surgery. 2006 Dec;140(6):874-81; discussion 881-2
17188133
J Clin Endocrinol Metab. 1996 Oct;81(10):3487-91
8855790
N Engl J Med. 2004 Apr 8;350(15):1516-25
15071126
J Bone Miner Res. 2001 Jan;16(1):113-9
11149474
Am J Med. 1990 Sep;89(3):327-34
2393037
Surg Gynecol Obstet. 1980 Sep;151(3):401-3
7404314
BMJ. 2000 Sep 9;321(7261):598-602
10977834
Am J Med. 1998 Feb;104(2):115-22
9528728
J Clin Endocrinol Metab. 2009 Feb;94(2):335-9
19193908
J Clin Epidemiol. 1997 Aug;50(8):967-73
9291883
J Intern Med. 2002 Jun;251(6):476-83
12028502
J Clin Endocrinol Metab. 2009 Feb;94(2):366-72
19193911
J Clin Endocrinol Metab. 2005 Jun;90(6):3326-30
15769995
J Clin Endocrinol Metab. 2007 May;92(5):1687-92
17284629
Eur J Cardiovasc Prev Rehabil. 2004 Feb;11(1):69-74
15167209
Eur J Endocrinol. 2005 Dec;153(6):915-27
16322399
Clin Endocrinol (Oxf). 1999 Mar;50(3):321-8
10435057
J Clin Endocrinol Metab. 2003 Feb;88(2):581-7
12574184
J Clin Endocrinol Metab. 2008 Sep;93(9):3462-70
18544625
Osteoporos Int. 1996;6(4):329-33
8883124
World J Surg. 1991 May-Jun;15(3):399-405; discussion 406-7
1853620
Surgery. 2005 Jun;137(6):632-8
15933631
Am J Med. 1993 Aug;95(2):197-202
8356983
Surgery. 2000 Dec;128(6):895-902
11114621
Surgery. 2008 Aug;144(2):290-8
18656638
BMJ. 2002 Oct 12;325(7368):807
12376441
J Clin Endocrinol Metab. 2002 Dec;87(12):5353-61
12466320
J Clin Endocrinol Metab. 2007 Aug;92(8):3114-21
17535997