@article{af517d7558e64872837647257dbfc3eb,
title = "Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus",
abstract = "The purpose of this review is to assess the most recent evidence in the management of primary hyperparathyroidism (PHPT) and provide updated recommendations for its evaluation, diagnosis and treatment. A Medline search of {"}Hyperparathyroidism. Primary{"} was conducted and the literature with the highest levels of evidence were reviewed and used to formulate recommendations. PHPT is a common endocrine disorder usually discovered by routine biochemical screening. PHPT is defined as hypercalcemia with increased or inappropriately normal plasma parathyroid hormone (PTH). It is most commonly seen after the age of 50 years, with women predominating by three to fourfold. In countries with routine multichannel screening, PHPT is identified earlier and may be asymptomatic. Where biochemical testing is not routine, PHPT is more likely to present with skeletal complications, or nephrolithiasis. Parathyroidectomy (PTx) is indicated for those with symptomatic disease. For asymptomatic patients, recent guidelines have recommended criteria for surgery, however PTx can also be considered in those who do not meet criteria, and prefer surgery. Non-surgical therapies are available when surgery is not appropriate. This review presents the current state of the art in the diagnosis and management of PHPT and updates the Canadian Position paper on PHPT. An overview of the impact of PHPT on the skeleton and other target organs is presented with international consensus. Differences in the international presentation of this condition are also summarized.",
keywords = "Diagnosis, Management, Osteoporosis, Primary hyperparathyroidism, Surgery, Treatment",
author = "Khan, {A. A.} and Hanley, {D. A.} and R. Rizzoli and J. Bollerslev and Young, {J. E.M.} and L. Rejnmark and R. Thakker and P. D{\textquoteright}Amour and T. Paul and {Van Uum}, S. and Shrayyef, {M. Zakaria} and D. Goltzman and S. Kaiser and Cusano, {N. E.} and R. Bouillon and L. Mosekilde and Kung, {A. W.} and Rao, {S. D.} and Bhadada, {S. K.} and Clarke, {B. L.} and J. Liu and Q. Duh and Lewiecki, {E. Michael} and F. Bandeira and R. Eastell and C. Marcocci and Silverberg, {S. J.} and R. Udelsman and Davison, {K. Shawn} and Potts, {J. T.} and Brandi, {M. L.} and Bilezikian, {J. P.}",
note = "Funding Information: In this Canadian position paper, we update our previously published guidelines on PHPT with international consensus []. Canadian participation was invited at the Fourth International Workshop held in Florence Italy 2013. Canadian representatives met international colleagues in Florence and developed key questions addressing evaluation, imaging, diagnosis, and management of PHPT. Canadian representatives collaborated with international colleagues and formalized evidence-based recommendations to each of the key questions listed. A detailed section on parathyroid imaging was developed as this was highlighted as a need by Canadian endocrinologists. This position paper was supported and endorsed by Canadian Endocrine Update, McMaster University, and Western University. We summarize recent evidence and provide recommendations pertaining to the evaluation, diagnosis, presentation, and management of PHPT. Publisher Copyright: {\textcopyright} 2016, The Author(s).",
year = "2017",
month = jan,
day = "1",
doi = "10.1007/s00198-016-3716-2",
language = "English (US)",
volume = "28",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "1",
}