Primary hyperparathyroidism in adults—(Part I) assessment and medical management: Position statement of the endocrine society of Australia, the Australian & New Zealand endocrine surgeons, and the Australian & New Zealand bone and mineral society
Methodological detailsADAPTE guideline adaptation, clinical consensus recommendations
- ADAPTE guideline adaptation
- Clinical consensus recommendations
Recommendations
As issued by the authors
Primary hyperparathyroidism (PHPT) is a biochemical diagnosis.
Measure serum calcium in patients with suggestive symptoms, reduced BMD or minimal trauma fractures, and in those with renal stones.
In hypercalcaemia, measure intact PTH, 25(OH)D, phosphate and renal function.
In established PHPT, assess BMD, vertebral fractures, urinary tract calculi/nephrocalcinosis and quantify urinary calcium excretion.
Parathyroidectomy is the only definitive treatment; warranted for all symptomatic patients and should be considered for asymptomatic patients without contraindications to surgery and with >10 years life expectancy.
Annual evaluation for disease progression in patients who do not undergo surgery.
Where diagnosis is unclear or risk-benefit ratio not obvious, multidisciplinary discussion and consensus management plan is appropriate.
Genetic testing for familial hyperparathyroidism is recommended in selected patients.
Original publication
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