Diagnosis of Asymptomatic Primary Hyperparathyroidism: Proceedings of the Fourth International Workshop
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2014-10-01
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Costa, Aline G. 
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Objective: Asymptomatic primary hyperparathyroidism (PHPT) is a common clinical problem. the purpose of this report is to provide an update on the use of diagnostic tests for this condition in clinical practice.Participants: This subgroup was constituted by the Steering Committee to address key questions related to the diagnosis of PHPT. Consensus was established at a closed meeting of the Expert Panel that followed.Evidence: Each question was addressed by a relevant literature search (on PubMed), and the data were presented for discussion at the group meeting.Consensus Process: Consensus was achieved by a group meeting. Statements were prepared by all authors, with comments relating to accuracy from the diagnosis subgroup and by representatives from the participating professional societies.Conclusions: We conclude that: 1) reference ranges should be established for serum PTH in vitamin D-replete healthy individuals; 2) second-and third-generation PTH assays are both helpful in the diagnosis of PHPT; 3) normocalcemic PHPT is a variant of the more common presentation of PHPT with hypercalcemia; 4) serum 25-hydroxyvitamin D concentrations should be measured and, if vitamin D insufficiency is present, it should be treated as part of any management course; 5) genetic testing has the potential to be useful in the differential diagnosis of familial hyperparathyroidism or hypercalcemia.
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Journal of Clinical Endocrinology & Metabolism. Washington: Endocrine Soc, v. 99, n. 10, p. 3570-3579, 2014.