Hyperparathyroidism

Jonathan A Phillips, D.O. and Bradly J Thrasher, DO Reviewed 06/2022

BASICS

DESCRIPTION

A dysfunction of the body’s normal regulatory feedback mechanisms resulting in excess production of parathyroid hormone (PTH)

Primary hyperparathyroidism (HPT): intrinsic parathyroid...

DIAGNOSIS

HISTORY

History of present illness
- Almost 80% of patients are asymptomatic.
- Kidney stones (15–20%)
- Osteitis fibrosa cystica (<5%) characterized by subperiosteal resorption of phalanges, taper...

TREATMENT

MEDICATION

Primary HPT: Operative management is curative; indications for surgical intervention are mentioned below. For those awaiting or unable to have surgery:
- Bisphosphonates (alendronate)...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Asymptomatic patients with primary HPT require serial monitoring of calcium and PTH.

Patient Monitoring

In patients with primary HPT who are asymptomatic, measurem...

REFERENCES

Bilezikian JP, Brandi ML, Eastell R, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth Internat...

ADDITIONAL READING

CODES

ICD10

E21.3 Hyperparathyroidism, unspecified
N25.81 Secondary hyperparathyroidism of renal origin
E21.1 Secondary hyperparathyroidism, not elsewhere classified
E21.0 Primary hyperparathyroidism
E21.2...

CLINICAL PEARLS

80% of patients with primary HPT are asymptomatic.
HPT is often detected by an incidental finding of hypercalcemia on a routine serum chemistry analysis.
Classic symptoms of HPT include ...

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