Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/28488
Title: Primary hyperparathyroidism in adults-(Part I) assessment and medical management: Position statement of the endocrine society of Australia, the Australian & New Zealand endocrine surgeons, and the Australian & New Zealand bone and mineral society.
Austin Authors: Milat, Frances;Ramchand, Sabashini K ;Herath, Madhuni;Gundara, Justin;Harper, Simon;Farrell, Stephen G ;Girgis, Christian M;Clifton-Bligh, Roderick;Schneider, Hans G;De Sousa, Sunita M C;Gill, Anthony J;Serpell, Jonathan;Taubman, Kim;Christie, James;Carroll, Richard W;Miller, Julie A;Grossmann, Mathis 
Affiliation: Surgery
Medicine (University of Melbourne)
Endocrinology
Department of Medicine, Nursing & Health Sciences, Monash University, Victoria, Australia
Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Victoria, Australia
Epworth Hospital Network, Victoria, Australia
Department of Surgery, The Royal Melbourne Hospital, Victoria, Australia
PRP Diagnostic Imaging, New South Wales, Australia
Department of Medicine, University of Melbourne, Victoria, Australia
Department of Endocrinology, St Vincent's Hospital, Victoria, Australia
Department of Medical Imaging, St Vincent's Hospital, Victoria, Australia
Monash University Department of Endocrine Surgery, Victoria, Australia
Department of General Surgery, The Alfred Hospital, Victoria, Australia
NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
Department of Surgery, University of Otago, Wellington, New Zealand
Department of Diabetes and Endocrinology, Westmead Hospital, New South Wales, Australia
Department of Surgery, Redland Hospital, Metro South and Faculty of Medicine, University of Queensland, Australia
Department of General Surgery, Wellington Regional Hospital, Wellington, New Zealand
Endocrine, Diabetes, and Research Centre, Wellington Regional Hospital, Wellington, New Zealand
Department of Endocrinology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, South Australia
Department of Endocrinology, Monash Health, Victoria, Australia
Department of Surgery, University of Melbourne, Victoria, Australia
South Australian Adult Genetics Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Victoria, Australia
Department of Endocrinology, Alfred Hospital, Victoria, Australia
Clinical Biochemistry Unit, Alfred Pathology Service, Alfred Health, Victoria, Australia
Kolling Institute, University of Sydney, New South Wales, Australia
Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
Department of Surgery, St Vincent's Hospital, Victoria, Australia
Department of Surgery, Logan Hospital, Metro South and School of Medicine and Dentistry, Griffith University, Queensland, Australia
Department of Surgery, Royal Children's Hospital, Victoria, Australia
Issue Date: 21-Dec-2021
Date: 2021
Publication information: Clinical Endocrinology 2021;
Abstract: To formulate clinical consensus recommendations on the presentation, assessment, and management of primary hyperparathyroidism (PHPT) in adults. Representatives from relevant Australian and New Zealand Societies used a systematic approach for adaptation of guidelines (ADAPTE) to derive an evidence-informed position statement addressing nine key questions. PHPT is a biochemical diagnosis. Serum calcium should be measured in patients with suggestive symptoms, reduced bone mineral density or minimal trauma fractures, and in those with renal stones. Other indications are detailed in the manuscript. In patients with hypercalcaemia, intact parathyroid hormone, 25-hydroxy vitamin D, phosphate, and renal function should be measured. In established PHPT, assessment of bone mineral density, vertebral fractures, urinary tract calculi/nephrocalcinosis and quantification of urinary calcium excretion is warranted. Parathyroidectomy is the only definitive treatment and is warranted for all symptomatic patients and should be considered for asymptomatic patients without contraindications to surgery and with >10 years life expectancy. In patients who do not undergo surgery, we recommend annual evaluation for disease progression. Where the diagnosis is not clear or the risk-benefit ratio is not obvious, multidisciplinary discussion and formulation of a consensus management plan is appropriate. Genetic testing for familial hyperparathyroidism is recommended in selected patients. These clinical consensus recommendations were developed to provide clinicians with contemporary guidance on the assessment and management of PHPT in adults. It is anticipated that improved health outcomes for individuals and the population will be achieved at a decreased cost to the community.
URI: https://ahro.austin.org.au/austinjspui/handle/1/28488
DOI: 10.1111/cen.14659
ORCID: 0000-0003-2776-2083
0000-0002-1545-0368
0000-0001-8261-3457
0000-0002-0834-1948
0000-0002-6755-8469
Journal: Clinical Endocrinology
PubMed URL: 34931708
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/34931708/
Type: Journal Article
Subjects: asymptomatic hyperparathyroidism
bone density
hypercalcemia
hyperparathyroidism
parathyroid carcinoma
parathyroid hormone
parathyroidectomy
renal calculi
Appears in Collections:Journal articles

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