2017•PubMedRequires access
[Diagnostic approach and treatment of primary hyperparathyroidism].
Willemijn Y. van der Plas, Milou E. Noltes, Anouk W. M. A. Schaeffers, Adrienne H. Brouwers, Anouk N.A. van der Horst-Schrivers, Schelto Kruijff
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Abstract
- Primary hyperparathyroidism (PHPT) is characterised by elevated serum calcium levels due to elevated levels, or insufficient suppression, of parathyroid hormone (PTH).- The incidence of PHPT has increased in recent years. This is mainly the result of more frequently performed routine measurements of serum calcium, e.g. as part of postmenopausal screening.- The classically described features of PHPT - bones and stones - are not always observed and most patients are asymptomatic.- Diagnosis of PHPT is only established by biochemical testing, not by imaging.- Ultrasound and technetium-99m sestamibi SPECT-CT are the first-choice imaging modalities. These investigations are necessary to localize the parathyroid adenomas and thereby facilitate minimal invasive parathyroidectomy (MIP).