Nonsurgical Management of Primary Hyperparathyroidism

Farford, Bryan; Presutti, R. John; Moraghan, Thomas J.
March 2007
Mayo Clinic Proceedings;Mar2007, Vol. 82 Issue 3, p351
Academic Journal
Primary hyperparathyroidism is the most common cause of hypercalcemia In the outpatient setting and is typically caused by a single benign parathyroid adenoma. Most patients with hyper-parathyroidism are postmenopausal women. Patients can be asymptomatic or minimally symptomatic. Parathyroidectomy is the definitive cure for primary hyperparathyroidism, and no medical therapies have been approved by the Food and Drug Administration for this disorder. Guidelines for surgery have been established by a National Institutes of Health consensus panel, but many patients do not meet these guidelines or have comorbid conditions that prohibit surgery. This review describes alternative treatment options for patients who decide against or are unable to proceed with surgery.


Related Articles

  • Treatment of refractory secondary hyperparathyroidism with ethanol injection: The importance of glandular volume. Douthat, Walter G.; Orozco, Santiago E.; De Arteaga, Javier; Massari, Pablo U. // Kidney International Supplement;Jun2003, Issue 85, p101 

    Treatment of refractory secondary hyperparathyroidism with ethanol injection: The importance of glandular volume. Background. Percutaneous ethanol injection treatment (PEIT) has been proposed as an alternative to surgery for patients with secondary hyperparathyroidism. The present study was...

  • Advantages of adjusting the initial dose of intravenous calcitriol according to PTH levels. Rodríguez-García, Minerva; Fernández-Martín, José Luis; De Castañeda, Jaime Ruiz; Hervás-Sánchez, José; Cannata-Andía, Jorge Benito // Kidney International Supplement;Jun2003, Issue 85, p79 

    Advantages of adjusting the initial dose of intravenous calcitriol according to PTH levels. Background. To assess the usefulness of starting calcitriol therapy with a dose proportional to the degree of hyperparathyroidism, 141 patients from 28 centers were treated with intravenous calcitriol for...

  • Primary Hyperparathyroidism-A Review of this Disorder and an Interesting Case Treated with Cinacalcet. Mohammed, Abdul Rafi; Amin, Peshraw // Turkish Journal of Endocrinology & Metabolism;2009, Vol. 13 Issue 2, p37 

    Primary hyperparathyroidism is not an uncommon disorder and there can be a delay in the diagnosis as it remains mostly asymptomatic. We discuss about this disorder and review the literature. Treatment options which include both surgical and medical therapy are also discussed. We also report an...

  • Clinical Pharmacokinetic and Pharmacodynamic Profile of Cinacalcet Hydrochloride. Padhi, Desmond; Harris, Robert // Clinical Pharmacokinetics;2009, Vol. 48 Issue 5, p303 

    Cinacalcet hydrochloride (cinacalcet) is a calcimimetic approved for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease (CKD) receiving dialysis and for the treatment of hypercalcaemia in patients with parathyroid carcinoma. Following oral administration, peak...

  • Paricalcitol Superior for Lowering iPTH. KELLER, DANIEL M. // Renal & Urology News;Sep2011, Vol. 10 Issue 9, p13 

    The article reports on a study conducted by Markus Ketteler and colleagues which reveals that paricalcitol is superior to cinacalcet in achieving target parathyroid hormone levels in patients with secondary hyperparathyroidism (SHPT). It uses 272 hemodialysis (HD) patients randomly assigned to...

  • News from the FDA.  // Patient Care;Nov2004, Vol. 38 Issue 11, p13 

    Presents news briefs concerning the U.S. Food and Drug Administration as of November 2004. Approval of the drug Sensipar for the treatment of secondary hyperparathyroidism and hypercalcemia; Fast-track designation assigned to Tetrabenazine, an investigational therapy for the treatment of chorea...

  • Limitations of Technetium 99m Sestamibi Scintigraphic Localization for primary Hyperparathyroidism Associated with Multiglandular Disease. Katz, Steven C.; Wang, Grace J.; Roses, Daniel F.; Kramer, Elissa L. // American Surgeon;Feb2003, Vol. 69 Issue 2, p170 

    Successful surgical treatment of primary hyperparathyroidism requires the localization and excision of the parathyroid tissue responsible for excessive parathyroid hormone secretion while ensuring that the patient will have sufficient endogenous parathyroid hormone production to maintain...

  • Primary Hyperparathyroidism in the Young Age Group: Particularities of Diagnostic and Therapeutic Schemes. Cupisti, Kenko; Raffel, Andreas; Dotzenrath, Cornelia; Krausch, Markus; Röher, Hans-Dietrich; Schulte, Klaus-Martin // World Journal of Surgery;Nov2004, Vol. 28 Issue 11, p1153 

    Primary hyperparathyroidism (pHPT) is a rare endocrine disease in children and young adults. The widespread use of new developments in pHPT surgery (i.e., unilateral and minimally invasive approaches) is based on the assumption that the solitary adenoma is the predominant intraoperative finding,...

  • Symposium on Evidence-Based Endocrine Surgery (3: Hyperparathyroidism). Åkerström, Göran // World Journal of Surgery;Nov2009, Vol. 33 Issue 11, p2219 

    The article discusses various reports published within the issue, including one by Carling and colleagues on the importance of recognizing familial parathyroid disease, another by Pasieka and colleagues on expected symptom alleviation after operation for primary hyperparathyroidism (HPT) and...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics