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Hyperparathyroidism

Michael Morkos, MD, MS and Sandy Botros, MD Reviewed 06/2019
 


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:

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

1
Bilezikian JP, Brandi ML, Eastell R, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endo...

CODES

ICD10

  • E21.3 Hyperparathyroidism, unspecified

  • E21.0 Primary hyperparathyroidism

  • E21.1 Secondary hyperparathyroidism, not elsewhere classified

  • E21.2 Other hyperparathyroidism

ICD9

  • 252.00 Hyperparathyroi...

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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