Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop
| Autor: | R. Eastell, A. Arnold, M. L. Brandi, E. M. Brown, P. D'Amour, D. A. Hanley, D. Sudhaker Rao, M. R. Rubin, D. Goltzman, S. J. Silverberg, S. J. Marx, M. Peacock, L. Mosekilde, R. Bouillon, E. M. Lewiecki |
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| Rok vydání: | 2009 |
| Předmět: |
Consensus
endocrine system diseases Endocrinology Diabetes and Metabolism Biochemistry (medical) Clinical Biochemistry DNA Mutational Analysis Avitaminosis Hyperparathyroidism Primary Biochemistry Diagnostic Techniques Endocrine Endocrinology Parathyroid Hormone Proto-Oncogene Proteins Humans Vitamin D Receptors Calcium-Sensing |
| Zdroj: | Eastell, R, Arnold, A, Brandi, M L, Brown, E M, D'Amour, P, Hanley, D A, Rao, D S, Rubin, M R, Goltzman, D, Silverberg, S J, Marx, S J, Peacock, M, Mosekilde, L, Bouillon, R & Lewiecki, E M 2009, ' Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop ', Journal of Clinical Endocrinology and Metabolism, vol. 94, no. 2, pp. 340-50 . https://doi.org/10.1210/jc.2008-1758 |
| ISSN: | 0021-972X |
| DOI: | 10.1210/jc.2008-1758 |
| Popis: | Udgivelsesdato: 2009-Feb OBJECTIVE: Asymptomatic primary hyperparathyroidism (PHPT) is a common clinical problem. The purpose of this report is to guide the use of diagnostic tests for this condition in clinical practice. PARTICIPANTS: Interested professional societies selected a representative for the consensus committee and provided funding for a one-day meeting. A subgroup of this committee set the program and developed key questions for review. Consensus was established at a closed meeting that followed. The conclusions were then circulated to the participating professional societies. 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) DNA sequence testing can be useful in familial hyperparathyroidism or hypercalcemia; 4) normocalcemic PHPT is a variant of the more common presentation of PHPT with hypercalcemia; 5) serum 25-hydroxyvitamin D levels should be measured and, if vitamin D insufficiency is present, it should be treated as part of any management course; and 6) the estimated glomerular filtration rate should be used to determine the level of kidney function in PHPT: an estimated glomerular filtration rate of less than 60 ml/min.1.73 m2 should be a benchmark for decisions about surgery in established asymptomatic PHPT. |
| Databáze: | OpenAIRE |
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