Diagnosis of Primary Hyperparathyroidism
How to work up hypercalcemia
What if the calcium is normal, but the PTH is high?
Parathyroid imaging can be obtained to guide surgical planning, but does not play a role in confirming the diagnosis. The diagnosis of primary hyperparathyroidism is based upon the laboratory assessments.
What are the symptoms of hyperparathyroidism?
The traditional symptoms of hyperparathyroidism are kidney stones or bone disease. While patients without these manifestations are often labeled as “asymptomatic,” almost no patients are truly asymptomatic. Unfortunately the symptoms of hyperparathyroidism are vague and non-specific, making it harder to recognize the disease. The symptoms also do not correlate at all with the severity of the laboratory findings. The most common symptoms are:
What are the benefits of timely diagnosis and treatment?
Should anyone be screened for this condition?
Yes. The only way to make this diagnosis is to have a high index of suspicion!
What are the treatment options?
Surgery is the only effective therapy for the disease. The disease never resolves and typically progresses over time, so surgical management is appropriate to consider in all patients that are reasonable surgical candidates. If patients are interested in watchful waiting, then labs should be checked annually and their BMD monitored for progression of their bone disease.
For more information
The UW Endocrine Surgery Program performs nearly 300 parathyroidectomies each year. Our Endocrine Surgery team includes Rebecca Sippel, MD, David Schneider, MD, MS, and Susan Pitt, MD, MPHS. Learn more about hyperparathyroidism diagnosis and treatment online. For questions about a patient or a referral, call the Endocrine Surgery Clinic at (608) 263-7502.