Primary hyperparathyroidism – new clinical forms of the disease

Czech version

Authors: Kateřina Zajíčková
Authors‘ workplace: Endokrinologický ústav, Praha
Published in: Vnitř Lék 2017; 63(9): 604-608
Category: Reviews

Overview

Primary hyperparathyroidism (PHPT) has been increasingly diagnosed incidentally in its asymptomatic form owing to calcium screening tests. This form of PHPT represents 80% in developed countries. Although PHPT patients are asymptomatic, target organ (bone and kidney) involvement is frequently observed. Mild PHPT is associated with a reduction of bone mineral densityand, moreover, with increased risk of vertebral fractures. The extent of a patient evaluation and indications for parathyroidectomy are based on expert guidelines from 2014. Normocalcemic variant of PHPT has been recently recognized, possibly with higher prevalence in general population than the hypercalcemic form of PHPT. Normal but with respect to hypercalcemia inadequately high parathormon levels characterize normohormonal PHPT. If a hereditary form of PHPT is suspected, genetic testing is recommended. Although there are new clinical forms of PHPT, parathyroidectomy still represents the only curative approach to PHPT followed by substantial osteoprotective effect.

Key words:
asymptomatic form – normocalcemic form – normohormonal form – parathyroidectomy – primary hyperparathyroidism – recent guidelines for the management PHPT

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