Primary hyperparathyroidism: Skeletal and non-skeletal effects, diagnosis and management
Abstract Primary hyperparathyroidism (PHPT) is the third most common endocrinopathy seen today, and is most frequently found in the 6th to 7th decade of life. PHPT can present with various degrees of symptoms, and can affect many organ systems, including the skeletal, renal, central nervous system a...
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| Veröffentlicht in: | Maturitas 2011-11, Vol.70 (3), p.246-255 |
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| creator | Pyram, Ronald Mahajan, Geeti Gliwa, Agnieszka |
| description | Abstract Primary hyperparathyroidism (PHPT) is the third most common endocrinopathy seen today, and is most frequently found in the 6th to 7th decade of life. PHPT can present with various degrees of symptoms, and can affect many organ systems, including the skeletal, renal, central nervous system and cardiovascular system. Despite this, the most common presentation of hyperparathyroidism is “asymptomatic” with the diagnosis being made incidentally with the initial finding of hypercalcemia on routine laboratory studies, leading to further investigation. Surgical versus medical management is usually based on factors such as age and complications related to hyperparathyroidism (i.e. the presence of renal stones, renal insufficiency and bone loss and significant increases in serum calcium). Treatment options include parathyroidectomy, bisphosphonates, calcitonin and calcimimetics. In this review, we discuss primary hyperparathyroidism in detail with a focus on clinical manifestations particularly in the elderly population. We highlight the indications for surgical versus medical management and compare some of the uses of newer therapeutic agents relative to traditional ones. |
| doi_str_mv | 10.1016/j.maturitas.2011.07.021 |
| format | Article |
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PHPT can present with various degrees of symptoms, and can affect many organ systems, including the skeletal, renal, central nervous system and cardiovascular system. Despite this, the most common presentation of hyperparathyroidism is “asymptomatic” with the diagnosis being made incidentally with the initial finding of hypercalcemia on routine laboratory studies, leading to further investigation. Surgical versus medical management is usually based on factors such as age and complications related to hyperparathyroidism (i.e. the presence of renal stones, renal insufficiency and bone loss and significant increases in serum calcium). Treatment options include parathyroidectomy, bisphosphonates, calcitonin and calcimimetics. In this review, we discuss primary hyperparathyroidism in detail with a focus on clinical manifestations particularly in the elderly population. We highlight the indications for surgical versus medical management and compare some of the uses of newer therapeutic agents relative to traditional ones.</description><identifier>ISSN: 0378-5122</identifier><identifier>EISSN: 1873-4111</identifier><identifier>DOI: 10.1016/j.maturitas.2011.07.021</identifier><identifier>PMID: 21943558</identifier><identifier>CODEN: MATUDK</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Age Factors ; Biological and medical sciences ; Bone Resorption - etiology ; Calcium - blood ; Cardiovascular diseases ; Diseases of the osteoarticular system ; Endocrinopathies ; Gynecology. Andrology. Obstetrics ; Humans ; Hypercalcemia ; Hypercalcemia - blood ; Hypercalcemia - etiology ; Hypercalciuria ; Hyperparathyroidism, Primary - complications ; Hyperparathyroidism, Primary - diagnosis ; Hyperparathyroidism, Primary - therapy ; Internal Medicine ; Kidney Calculi - etiology ; Medical sciences ; Neuro-psychiatric symptoms ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Obstetrics and Gynecology ; Osteoporosis ; Osteoporosis. Osteomalacia. Paget disease ; Parathyroid Hormone - blood ; Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases) ; Primary hyperparathyroidism – PHTP ; Puberal and climacteric disorders (male and female) ; Renal Insufficiency - etiology</subject><ispartof>Maturitas, 2011-11, Vol.70 (3), p.246-255</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2011 Elsevier Ireland Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Ireland Ltd. 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PHPT can present with various degrees of symptoms, and can affect many organ systems, including the skeletal, renal, central nervous system and cardiovascular system. Despite this, the most common presentation of hyperparathyroidism is “asymptomatic” with the diagnosis being made incidentally with the initial finding of hypercalcemia on routine laboratory studies, leading to further investigation. Surgical versus medical management is usually based on factors such as age and complications related to hyperparathyroidism (i.e. the presence of renal stones, renal insufficiency and bone loss and significant increases in serum calcium). Treatment options include parathyroidectomy, bisphosphonates, calcitonin and calcimimetics. In this review, we discuss primary hyperparathyroidism in detail with a focus on clinical manifestations particularly in the elderly population. We highlight the indications for surgical versus medical management and compare some of the uses of newer therapeutic agents relative to traditional ones.</description><subject>Age Factors</subject><subject>Biological and medical sciences</subject><subject>Bone Resorption - etiology</subject><subject>Calcium - blood</subject><subject>Cardiovascular diseases</subject><subject>Diseases of the osteoarticular system</subject><subject>Endocrinopathies</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hypercalcemia</subject><subject>Hypercalcemia - blood</subject><subject>Hypercalcemia - etiology</subject><subject>Hypercalciuria</subject><subject>Hyperparathyroidism, Primary - complications</subject><subject>Hyperparathyroidism, Primary - diagnosis</subject><subject>Hyperparathyroidism, Primary - therapy</subject><subject>Internal Medicine</subject><subject>Kidney Calculi - etiology</subject><subject>Medical sciences</subject><subject>Neuro-psychiatric symptoms</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Obstetrics and Gynecology</subject><subject>Osteoporosis</subject><subject>Osteoporosis. Osteomalacia. Paget disease</subject><subject>Parathyroid Hormone - blood</subject><subject>Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)</subject><subject>Primary hyperparathyroidism – PHTP</subject><subject>Puberal and climacteric disorders (male and female)</subject><subject>Renal Insufficiency - etiology</subject><issn>0378-5122</issn><issn>1873-4111</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkl1r1UAQhhdR7Gn1L2huxBsTdzbZj3ghlGJVKChUwbtlspm0e5psjruJcP69iee0gldeLQzPvLPzMIy9BF4AB_V2Www4zdFPmArBAQquCy7gEduA0WVeAcBjtuGlNrkEIU7YaUpbzrnkZfWUnQioq1JKs2E_vkY_YNxnt_sdxR1GnG73cfStT8O77PqOepqwzzC0WRhDnu4L1HXkpvQmaz3ehDH59IcZMOANDRSmZ-xJh32i58f3jH2__PDt4lN-9eXj54vzq9xJAVPuOiFbBU0jBOoGhHS64bIGp1XtZNlh0wqnKm3Q8XXzmpCDcU4oqbpam_KMvT7k7uL4c6Y02cEnR32PgcY5WVMrI2pj6oXUB9LFMaVInd0ddrfA7Zptt_bBql2tWq7tYnXpfHGcMTcDtQ999xoX4NURwOSw7yIG59NfrlKllkot3PmBo8XIL0_RJucpOGp9XHTadvT_8Zn3_2S43ge_jL2jPaXtOMewCLdgk7DcXq9HsN4AAOdC1ar8DcMlr9c</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>Pyram, Ronald</creator><creator>Mahajan, Geeti</creator><creator>Gliwa, Agnieszka</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111101</creationdate><title>Primary hyperparathyroidism: Skeletal and non-skeletal effects, diagnosis and management</title><author>Pyram, Ronald ; Mahajan, Geeti ; Gliwa, Agnieszka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-cf25d61bb22a7b125c7b0591c769c53fabd2c6478ac010169ea018cc2656f9783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Age Factors</topic><topic>Biological and medical sciences</topic><topic>Bone Resorption - etiology</topic><topic>Calcium - blood</topic><topic>Cardiovascular diseases</topic><topic>Diseases of the osteoarticular system</topic><topic>Endocrinopathies</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hypercalcemia</topic><topic>Hypercalcemia - blood</topic><topic>Hypercalcemia - etiology</topic><topic>Hypercalciuria</topic><topic>Hyperparathyroidism, Primary - complications</topic><topic>Hyperparathyroidism, Primary - diagnosis</topic><topic>Hyperparathyroidism, Primary - therapy</topic><topic>Internal Medicine</topic><topic>Kidney Calculi - etiology</topic><topic>Medical sciences</topic><topic>Neuro-psychiatric symptoms</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Obstetrics and Gynecology</topic><topic>Osteoporosis</topic><topic>Osteoporosis. Osteomalacia. Paget disease</topic><topic>Parathyroid Hormone - blood</topic><topic>Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)</topic><topic>Primary hyperparathyroidism – PHTP</topic><topic>Puberal and climacteric disorders (male and female)</topic><topic>Renal Insufficiency - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pyram, Ronald</creatorcontrib><creatorcontrib>Mahajan, Geeti</creatorcontrib><creatorcontrib>Gliwa, Agnieszka</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Maturitas</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pyram, Ronald</au><au>Mahajan, Geeti</au><au>Gliwa, Agnieszka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Primary hyperparathyroidism: Skeletal and non-skeletal effects, diagnosis and management</atitle><jtitle>Maturitas</jtitle><addtitle>Maturitas</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>70</volume><issue>3</issue><spage>246</spage><epage>255</epage><pages>246-255</pages><issn>0378-5122</issn><eissn>1873-4111</eissn><coden>MATUDK</coden><abstract>Abstract Primary hyperparathyroidism (PHPT) is the third most common endocrinopathy seen today, and is most frequently found in the 6th to 7th decade of life. 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| subjects | Age Factors Biological and medical sciences Bone Resorption - etiology Calcium - blood Cardiovascular diseases Diseases of the osteoarticular system Endocrinopathies Gynecology. Andrology. Obstetrics Humans Hypercalcemia Hypercalcemia - blood Hypercalcemia - etiology Hypercalciuria Hyperparathyroidism, Primary - complications Hyperparathyroidism, Primary - diagnosis Hyperparathyroidism, Primary - therapy Internal Medicine Kidney Calculi - etiology Medical sciences Neuro-psychiatric symptoms Non tumoral diseases. Target tissue resistance. Benign neoplasms Obstetrics and Gynecology Osteoporosis Osteoporosis. Osteomalacia. Paget disease Parathyroid Hormone - blood Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases) Primary hyperparathyroidism – PHTP Puberal and climacteric disorders (male and female) Renal Insufficiency - etiology |
| title | Primary hyperparathyroidism: Skeletal and non-skeletal effects, diagnosis and management |
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