Assessment of hyperparathyroidism

Abstract

Parathyroid hormone (PTH) in concert with 1,25-dihydroxyvitamin D regulates the level of calcium and phosphate from skeletal, renal, and intestinal actions. Hyperparathyroidism (HPT) is a common endocrinological disease characterized by an elevated parathyroid hormone (PTH). Hyperparathyroidism can be primary (autonomous hyperfunction of one or more parathyroid glands), secondary (physiological response to hypocalcemia due to an underlying disease), or tertiary (post renal transplantation).Primary HPT may be minimally symptomatic and coincidentally found. However, the signs and symptoms of hypercalcemia include renal, neurocognitive, musculoskeletal, gastrointestinal, and cardiovascular manifestations. Differential diagnoses that should be considered include vitamin D deficiency, malignancy, familial hypocalciuric hypercalcemia, and lithium or thiazide therapy.The definitive treatment of primary HPT is parathyroidectomy; however, the clinical and biochemical features may suggest that observation alone is optimal for the patient.