BMJ Best Practice Podcast Primary hyperparathyroidism
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Sep 11, 2023 Primary hyperparathyroidism is a common disorder affecting both men and women. The podcast discusses the diagnosis and management of the condition, including surgery and medication. It also covers the indications for surgery, the use of bisphosphonates, and the challenges in diagnosing symptoms and potential complications. The causes and management of primary hyperparathyroidism, as well as addressing patient questions, are also explored.
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What Primary Hyperparathyroidism Is
- Primary hyperparathyroidism is caused by a benign parathyroid tumour that secretes excess parathyroid hormone leading to hypercalcemia.
- Diagnosis requires elevated serum-adjusted calcium with an elevated or inappropriately normal parathyroid hormone.
Always Test Calcium And PTH
- Check serum-adjusted calcium and parathyroid hormone to diagnose primary hyperparathyroidism.
- Remember normal physiology should suppress PTH when calcium is high, so an elevated or inappropriately normal PTH indicates disease.
Many Cases Are Incidentally Found
- Most patients today are diagnosed incidentally because serum calcium is checked more often in primary care.
- Traditional hypercalcemia symptoms include polyuria, fatigue, bone and muscle pain, and constipation.