Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop

J Clin Endocrinol Metab. 2014 Oct;99(10):3570-9. doi: 10.1210/jc.2014-1414. Epub 2014 Aug 27.

Abstract

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.

Publication types

  • Consensus Development Conference

MeSH terms

  • Asymptomatic Diseases*
  • Education
  • Endocrinology / standards*
  • Evidence-Based Medicine / standards*
  • Humans
  • Hyperparathyroidism, Primary / blood
  • Hyperparathyroidism, Primary / diagnosis*
  • Practice Guidelines as Topic*