Recent advances in the understanding and management of primary hyperparathyroidism

F1000Res. 2020 Feb 25:9:F1000 Faculty Rev-143. doi: 10.12688/f1000research.21569.1. eCollection 2020.

Abstract

Primary hyperparathyroidism is a hormonal disorder whose prevalence is approximately 1-2% in the United States of America. The disease has become more recognizable to clinicians in an earlier phase and, at present, patients can be diagnosed with "classic", "normocalcemic", "normohormonal", or "mild, asymptomatic" primary hyperparathyroidism. Surgery, with a focused parathyroidectomy when possible, or a four-gland exploration, is the only way to cure the disease. Cure is determined by use of intra-operative parathyroid hormone monitoring with long-term cure rates ranging from 90-95%. Newer adjuncts to surgery include CT or PET imaging and near-infrared immunofluorescence. This article highlights updates in parathyroid disease and advances in parathyroid surgery; it does not provide a comprehensive summary of the disease process or a review of surgical indications, which can be found in the AAES guidelines or NIH Symposium on primary hyperparathyroidism.

Keywords: primary hyperparathyroidism.

Publication types

  • Review

MeSH terms

  • Humans
  • Hyperparathyroidism, Primary*
  • Monitoring, Intraoperative
  • Parathyroid Hormone
  • Parathyroidectomy

Substances

  • Parathyroid Hormone

Grants and funding

The author(s) declared that no grants were involved in supporting this work.