When would I use medical therapies for the treatment of primary hyperparathyroidism?

Authors

  • Rachel K. Crowley,

    1. Department of Endocrinology, University Hospital Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
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  • Neil J. Gittoes

    Corresponding author
    1. Department of Endocrinology, University Hospital Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
    • Correspondence: Dr Neil Gittoes, Department of Medicine, Old Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, UK. E-mail: Neil.Gittoes@uhb.nhs.uk

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Summary

Although there may be controversy surrounding the indications for parathyroidectomy in primary hyperparathyroidism, it remains the only accepted definitive therapy. However, even if parathyroidectomy is indicated, some patients refuse surgery, are medically unfit or have residual or recurrent disease inaccessible to further surgery. Some of these patients may be suitable for long-term observation but others require intervention for management of symptomatic or moderate to severe hypercalcaemia, loss of bone mineral density or renal calculi. The selection of a suitable therapy for each patient should be individualized.

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