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
File version
Author(s)
Ramchand, Sabashini K
Herath, Madhuni
Gundara, Justin
Harper, Simon
Farrell, Stephen
Girgis, Christian M
Clifton-Bligh, Roderick
Schneider, Hans G
De Sousa, Sunita MC
Gill, Anthony J
Serpell, Jonathan
Taubman, Kim
Christie, James
Carroll, Richard W
et al.
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
License
Abstract
Objective: To formulate clinical consensus recommendations on the presentation, assessment, and management of primary hyperparathyroidism (PHPT) in adults. Methods: Representatives from relevant Australian and New Zealand Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing nine key questions. Results: PHPT is a biochemical diagnosis. Serum calcium should be measured in patients with suggestive symptoms, reduced bone mineral density or minimal trauma fractures, and in those with renal stones. Other indications are detailed in the manuscript. In patients with hypercalcaemia, intact parathyroid hormone, 25-hydroxy vitamin D, phosphate, and renal function should be measured. In established PHPT, assessment of bone mineral density, vertebral fractures, urinary tract calculi/nephrocalcinosis and quantification of urinary calcium excretion is warranted. Parathyroidectomy is the only definitive treatment and is warranted for all symptomatic patients and should be considered for asymptomatic patients without contraindications to surgery and with >10 years life expectancy. In patients who do not undergo surgery, we recommend annual evaluation for disease progression. Where the diagnosis is not clear or the risk-benefit ratio is not obvious, multidisciplinary discussion and formulation of a consensus management plan is appropriate. Genetic testing for familial hyperparathyroidism is recommended in selected patients. Conclusions: These clinical consensus recommendations were developed to provide clinicians with contemporary guidance on the assessment and management of PHPT in adults. It is anticipated that improved health outcomes for individuals and the population will be achieved at a decreased cost to the community.
Journal Title
Clinical Endocrinology
Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
This publication has been entered as an advanced online version in Griffith Research Online.
Access the data
Related item(s)
Subject
Clinical sciences
Endocrinology
Science & Technology
Life Sciences & Biomedicine
asymptomatic hyperparathyroidism
bone density
Metabolism
Persistent link to this record
Citation
Milat, F; Ramchand, SK; Herath, M; Gundara, J; Harper, S; Farrell, S; Girgis, CM; Clifton-Bligh, R; Schneider, HG; De Sousa, SMC; Gill, AJ; Serpell, J; Taubman, K; Christie, J; Carroll, RW; et al., 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, Clinical Endocrinology, 2021