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Primary hyperparathyroidism

Last edited: 4/13/2026

Overview

Primary hyperparathyroidism (PHPT) is characterized by excessive parathyroid hormone (PTH) secretion leading to hypercalcemia and related metabolic disturbances 12.

Diagnosis

  • Key Diagnostic Criteria: Elevated serum calcium and PTH levels 12.
  • Recommended Tests:
    • - Serum calcium and PTH measurements 12. - Urinary calcium excretion 12. - Imaging studies (ultrasound, sestamibi scan) for localization of parathyroid adenomas 111518.
  • Grading:
    • - Mild PHPT: Mild hypercalcemia with no significant symptoms 220. - Severe PHPT: Significant hypercalcemia with multiple complications (renal stones, osteoporosis) 114.

    Management

  • First-Line Treatment:
    • - Surgical Intervention: Parathyroidectomy is the definitive treatment, especially for symptomatic or severe cases 11718. - Minimally Invasive Techniques: Recommended for suitable patients to reduce complications and improve outcomes 162125.
  • Adjunctive Treatments:
    • - Vitamin D Supplementation: Beneficial in patients with concurrent vitamin D deficiency, improving bone health and potentially reducing PTH levels 71012222633. - Calcium Supplementation: May reduce nephrolithiasis risk preoperatively 1141.

    Special Populations

  • Pregnancy: Management requires careful monitoring of maternal and fetal calcium levels; magnesium sulfate can be used for hypercalcemia 5253.
  • Pediatrics: Rare but can present with complications like nephrolithiasis; early diagnosis and intervention are crucial 51.
  • Elderly: Increased risk of complications; individualized management considering comorbidities 220.
  • Comorbidities:
    • - Renal Disease: Close monitoring of renal function due to hypercalcemia effects 1558. - Osteoporosis: Aggressive management to prevent fractures 44.

    Key Recommendations

  • Surgical Referral: Indicated for symptomatic patients, those with severe hypercalcemia, or persistent biochemical abnormalities despite medical management (Evidence: Strong 117).
  • Vitamin D Supplementation: Consider in patients with PHPT and vitamin D deficiency to improve bone health (Evidence: Moderate 710122226).
  • Minimally Invasive Parathyroidectomy: Preferred approach for suitable patients to enhance efficacy and reduce complications (Evidence: Moderate 162125).

    • References

    1 Vantyghem MC, Mirallié E, Al-Salameh A, Aubert S, Barraud S, Baud G et al.. French expert consensus statement on diagnosis and management of primary hyperparathyroidism. Annales d'endocrinologie 2025. link 2 Kamenicky P, Mirallie E, Hindie E, Vantyghem MC, Brunaud L. Chapter 0: Introduction to the consensus on primary hyperparathyroidism from the French Society of Endocrinology, French speaking Association of Endocrine Surgery and French Society of Nuclear Medicine. Annales d'endocrinologie 2025. link 3 Baud G, Espiard S, Buffet C, Ben Hamou A, Henry H, Paladino NC et al.. Chapter 11: Treatment modalities. Annales d'endocrinologie 2025. link 4 Anastasilakis AD, Yavropoulou MP, Kassi E, Adamidou F, Vryonidou A, Tournis S et al.. Diagnosis and management of primary hyperparathyroidism: recommendations from the Bone Section of the Hellenic Endocrine Society. Hormones (Athens, Greece) 2025. link 5 Ladsous M, Deguelte S, Hindié E, Caiazzo R, Delemer B. Chapter 15: Recurrent or persistent primary hyperparathyroidism, parathyromatosis. Annales d'endocrinologie 2025. link 6 Sheu NO, Soelling SJ, Awtry JA, Mahvi DA, Nehs MA, Doherty GM et al.. Streamlining Health Care Access for Patients With Primary Hyperparathyroidism: A Quality Improvement Pilot Program. The Journal of surgical research 2025. link 7 Pallone SG, Ohe MN, Dos Santos LM, Nacaguma IO, Kunii IS, da Silva REC et al.. Vitamin D supplementation in primary hyperparathyroidism: effects on 1,25(OH). Journal of endocrinological investigation 2025. link 8 Miller JA, Gundara J, Harper S, Herath M, Ramchand SK, Farrell S et al.. Primary hyperparathyroidism in adults-(Part II) surgical management and postoperative follow-up: Position statement of the Endocrine Society of Australia, The Australian & New Zealand Endocrine Surgeons, and The Australian & New Zealand Bone and Mineral Society. Clinical endocrinology 2024. link 9 Costa-Guda J, Corrado K, Bellizzi J, Saria E, Saucier K, Guemes-Aragon M et al.. Influence of Vitamin D Deficiency on Cyclin D1-Induced Parathyroid Tumorigenesis. Endocrinology 2023. link 10 Song A, Zhao H, Yang Y, Liu S, Nie M, Wang O et al.. Safety and efficacy of common vitamin D supplementation in primary hyperparathyroidism and coexistent vitamin D deficiency and insufficiency: a systematic review and meta-analysis. Journal of endocrinological investigation 2021. link 11 Carral F, Ayala MDC, Jiménez AI, García C, Robles MI, Vega V. High capacity of ultrasound for locating parathyroid adenomas in endocrinology (the ETIEN 4 study). Endocrinologia, diabetes y nutricion 2020. link 12 Loh HH, Lim LL, Yee A, Loh HS, Vethakkan SR. Effect of vitamin D replacement in primary hyperparathyroidism with concurrent vitamin D deficiency: a systematic review and meta-analysis. Minerva endocrinologica 2019. link 13 Sanapureddy P, Garla VV, Pabbidi MR. Primary hyperparathyroidism: Labs to order, Tx to consider. The Journal of family practice 2018. link 14 Cristina EV, Alberto F. Management of familial hyperparathyroidism syndromes: MEN1, MEN2, MEN4, HPT-Jaw tumour, Familial isolated hyperparathyroidism, FHH, and neonatal severe hyperparathyroidism. Best practice & research. Clinical endocrinology & metabolism 2018. link 15 Verdelli C, Corbetta S. MECHANISMS IN ENDOCRINOLOGY: Kidney involvement in patients with primary hyperparathyroidism: an update on clinical and molecular aspects. European journal of endocrinology 2017. link 16 Mehrabibahar M, Mousavi Z, Sadeghi R, Layegh P, Nouri M, Asadi M. Feasibility and safety of minimally invasive radioguided parathyroidectomy using very low intraoperative dose of Tc-99m MIBI. International journal of surgery (London, England) 2017. link 17 Wilhelm SM, Wang TS, Ruan DT, Lee JA, Asa SL, Duh QY et al.. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA surgery 2016. link 18 Pappu R, Jabbour SA, Reginato AM, Reginato AJ. Musculoskeletal manifestations of primary hyperparathyroidism. Clinical rheumatology 2016. link 19 Randle RW, Balentine CJ, Wendt E, Schneider DF, Chen H, Sippel RS. Should vitamin D deficiency be corrected before parathyroidectomy?. The Journal of surgical research 2016. link 20 Vélayoudom-Céphise FL, Wémeau JL. Primary hyperparathyroidism and vitamin D deficiency. Annales d'endocrinologie 2015. link 21 Wang TS, Pasieka JL, Carty SE. Techniques of parathyroid exploration at North American endocrine surgery fellowship programs: what the next generation is being taught. American journal of surgery 2014. link 22 Eastell R, Brandi ML, Costa AG, D'Amour P, Shoback DM, Thakker RV. Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. The Journal of clinical endocrinology and metabolism 2014. link 23 Udelsman R, Åkerström G, Biagini C, Duh QY, Miccoli P, Niederle B et al.. The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. The Journal of clinical endocrinology and metabolism 2014. link 24 Marcocci C, Bollerslev J, Khan AA, Shoback DM. Medical management of primary hyperparathyroidism: proceedings of the fourth International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism. The Journal of clinical endocrinology and metabolism 2014. link 25 Silverberg SJ, Clarke BL, Peacock M, Bandeira F, Boutroy S, Cusano NE et al.. Current issues in the presentation of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. The Journal of clinical endocrinology and metabolism 2014. link 26 Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C et al.. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. The Journal of clinical endocrinology and metabolism 2014. link 27 Fu QY, Ma L, Yang ZB, Pao T. Multiple organ dysfunction caused by parathyroid adenoma-induced primary hyperparathyroidism. Nigerian journal of clinical practice 2014. link 28 Aspinall SR, Nicholson S, Bliss RD, Lennard TW. The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice. Annals of the Royal College of Surgeons of England 2012. link 29 Langdahl BL, Ralston SH. Diagnosis and management of primary hyperparathyroidism in Europe. QJM : monthly journal of the Association of Physicians 2012. link 30 Macfarlane DP, Yu N, Donnan PT, Leese GP. Should 'mild primary hyperparathyroidism' be reclassified as 'insidious': is it time to reconsider?. Clinical endocrinology 2011. link 31 Hong JC, Morris LF, Park EJ, Ituarte PH, Lee CH, Yeh MW. Transient increases in intraoperative parathyroid levels related to anesthetic technique. Surgery 2011. link 32 Mikhail N. Clinical significance of vitamin D deficiency in primary hyperparathyroidism, and safety of vitamin D therapy. Southern medical journal 2011. link 33 Rankin W. Primary hyperparathyroidism - is vitamin D supplementation safe?. Australian family physician 2011. link 34 Ruggieri F, Chiesa A, Schorn K, Strobel K, Maggiorini M, Schmid C. Vanishing polyuria and respiratory failure. BMJ case reports 2010. link 35 Akinci B, Demir T, Yener S, Comlekci A, Binicier O, Ozdogan O et al.. Beneficial effect of endocrinologist-performed ultrasonography on preoperative parathyroid adenoma localization. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2009. link 36 Tucci JR. Vitamin D therapy in patients with primary hyperparathyroidism and hypovitaminosis D. European journal of endocrinology 2009. link 37 Shindo ML, Rosenthal JM, Lee T. Minimally invasive parathyroidectomy using local anesthesia with intravenous sedation and targeted approaches. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2008. link 38 Gurney TA, Orloff LA. Otolaryngologist-head and neck surgeon-performed ultrasonography for parathyroid adenoma localization. The Laryngoscope 2008. link 39 Grubbs EG, Rafeeq S, Jimenez C, Feng L, Lee JE, Evans DB et al.. Preoperative vitamin D replacement therapy in primary hyperparathyroidism: safe and beneficial?. Surgery 2008. link 40 Clerici T, Warschkow R, Triponez F, Brändle M. National survey on the management of primary hyperparathyroidism by Swiss endocrinologists. Langenbeck's archives of surgery 2007. link 41 Cooperberg MR, Duh QY, Stackhouse GB, Stoller ML. Oral calcium supplementation associated with decreased likelihood of nephrolithiasis prior to surgery for hyperparathyroidism. International journal of urology : official journal of the Japanese Urological Association 2007. link 42 Rubello D, Giannini S, Martini C, Piotto A, Rampin L, Fanti S et al.. Minimally invasive radio-guided parathyroidectomy. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 2006. link 43 Boudou P, Ibrahim F, Cormier C, Chabas A, Sarfati E, Souberbielle JC. Third- or second-generation parathyroid hormone assays: a remaining debate in the diagnosis of primary hyperparathyroidism. The Journal of clinical endocrinology and metabolism 2005. link 44 Saleem TF, Horwith M, Stack BC. Significance of primary hyperparathyroidism in the management of osteoporosis. Otolaryngologic clinics of North America 2004. link 45 Kell MR, Sweeney KJ, Moran CJ, Flanagan F, Kerin MJ, Gorey TF. Minimally invasive parathyroidectomy with operative ultrasound localization of the adenoma. Surgical endoscopy 2004. link 46 Gallagher SF, Denham DW, Murr MM, Norman JG. The impact of minimally invasive parathyroidectomy on the way endocrinologists treat primary hyperparathyroidism. Surgery 2003. link00414-8) 47 Mahadevia PJ, Sosa JA, Levine MA, Zeiger MA, Powe NR. Clinical management of primary hyperparathyroidism and thresholds for surgical referral: a national study examining concordance between practice patterns and consensus panel recommendations. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2003. link 48 Rubin MR, Silverberg SJ. Rheumatic manifestations of primary hyperparathyroidism and parathyroid hormone therapy. Current rheumatology reports 2002. link 49 Peter SA, Brignol YF. Myxedema masking primary hyperparathyroidism. Journal of the National Medical Association 1993. link 50 Davies C, Demeure MJ, St John A, Edis AJ. Study of intact (1-84) parathyroid hormone secretion in patients undergoing parathyroidectomy. World journal of surgery 1990. link 51 Stone WM, van Heerden JA, Zimmerman D. An 8-year-old patient with complicated primary hyperparathyroidism. Journal of pediatric surgery 1989. link80085-5) 52 Higgins RV, Hisley JC. Primary hyperparathyroidism in pregnancy. A report of two cases. The Journal of reproductive medicine 1988. link 53 Rajala B, Abbasi RA, Hutchinson HT, Taylor T. Acute pancreatitis and primary hyperparathyroidism in pregnancy: treatment of hypercalcemia with magnesium sulfate. Obstetrics and gynecology 1987. link 54 Broulik PD, Stĕpán JJ, Pacovský V. Primary hyperparathyroidism and hyperuricaemia are associated but not correlated with indicators of bone turnover. Clinica chimica acta; international journal of clinical chemistry 1987. link90128-8) 55 Posillico JT, Srikanta S, Eisenbarth G, Quaranta V, Kajiji S, Brown EM. Binding of monoclonal antibody (4F2) to its cell surface antigen on dispersed adenomatous parathyroid cells raises cytosolic calcium and inhibits parathyroid hormone secretion. The Journal of clinical endocrinology and metabolism 1987. link 56 Gutekunst R, Valesky A, Borisch B, Hafermann W, Kiffner E, Thies E et al.. Parathyroid localization. The Journal of clinical endocrinology and metabolism 1986. link 57 Bennett JM, Steyn AF. Ultrasonography in the localization of parathyroid adenomas. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 1983. link 58 Broadus AE. Nephrolithiasis and hyperparathyroidism. Hospital practice (Office ed.) 1982. link 59 Paloyan D, Simonowitz D, Paloyan E, Snyder TJ. Pancreatitis associated with primary hyperparathyroidism. The American surgeon 1982. link 60 Tamura K, Shimaoka K, Spaulding S, Shedd D. Association between primary hyperparathyroidism and previous irradiation. Journal of surgical oncology 1982. link 61 Schantz A. The microscopical pathology of primary parathyroid hyperplasia. Annals of clinical and laboratory science 1979. link 62 Cooper RA, Riley JW, Middleton WR, Wiseman JC, Hales IB. Transient metastatic calcification in primary hyperparathyroidism. Australian and New Zealand journal of medicine 1978. link 63 Crocker EF, Bautovich GJ, Jellins J. Gray-scale echographic visualization of a parathyroid adenoma. Radiology 1978. link 64 Sheridan P. Presentation of primary hyperparathyroidism to a general medical unit. Postgraduate medical journal 1978. link 65 Salant DJ, Rabkin R. An unusual hormonal cause of hypertension and hypokalaemia. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde 1975. link

    Original source

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      French expert consensus statement on diagnosis and management of primary hyperparathyroidism. — Vantyghem MC, Mirallié E, Al-Salameh A, Aubert S, Barraud S, Baud G et al. Annales d'endocrinologie (2025)
    2. [2]
      Chapter 0: Introduction to the consensus on primary hyperparathyroidism from the French Society of Endocrinology, French speaking Association of Endocrine Surgery and French Society of Nuclear Medicine. — Kamenicky P, Mirallie E, Hindie E, Vantyghem MC, Brunaud L Annales d'endocrinologie (2025)
    3. [3]
      Chapter 11: Treatment modalities. — Baud G, Espiard S, Buffet C, Ben Hamou A, Henry H, Paladino NC et al. Annales d'endocrinologie (2025)
    4. [4]
      Diagnosis and management of primary hyperparathyroidism: recommendations from the Bone Section of the Hellenic Endocrine Society. — Anastasilakis AD, Yavropoulou MP, Kassi E, Adamidou F, Vryonidou A, Tournis S et al. Hormones (Athens, Greece) (2025)
    5. [5]
      Chapter 15: Recurrent or persistent primary hyperparathyroidism, parathyromatosis. — Ladsous M, Deguelte S, Hindié E, Caiazzo R, Delemer B Annales d'endocrinologie (2025)
    6. [6]
      Streamlining Health Care Access for Patients With Primary Hyperparathyroidism: A Quality Improvement Pilot Program. — Sheu NO, Soelling SJ, Awtry JA, Mahvi DA, Nehs MA, Doherty GM et al. The Journal of surgical research (2025)
    7. [7]
      Vitamin D supplementation in primary hyperparathyroidism: effects on 1,25(OH) — Pallone SG, Ohe MN, Dos Santos LM, Nacaguma IO, Kunii IS, da Silva REC et al. Journal of endocrinological investigation (2025)
    8. [8]
      Primary hyperparathyroidism in adults-(Part II) surgical management and postoperative follow-up: Position statement of the Endocrine Society of Australia, The Australian & New Zealand Endocrine Surgeons, and The Australian & New Zealand Bone and Mineral Society. — Miller JA, Gundara J, Harper S, Herath M, Ramchand SK, Farrell S et al. Clinical endocrinology (2024)
    9. [9]
      Influence of Vitamin D Deficiency on Cyclin D1-Induced Parathyroid Tumorigenesis. — Costa-Guda J, Corrado K, Bellizzi J, Saria E, Saucier K, Guemes-Aragon M et al. Endocrinology (2023)
    10. [10]
      Safety and efficacy of common vitamin D supplementation in primary hyperparathyroidism and coexistent vitamin D deficiency and insufficiency: a systematic review and meta-analysis. — Song A, Zhao H, Yang Y, Liu S, Nie M, Wang O et al. Journal of endocrinological investigation (2021)
    11. [11]
      High capacity of ultrasound for locating parathyroid adenomas in endocrinology (the ETIEN 4 study). — Carral F, Ayala MDC, Jiménez AI, García C, Robles MI, Vega V Endocrinologia, diabetes y nutricion (2020)
    12. [12]
      Effect of vitamin D replacement in primary hyperparathyroidism with concurrent vitamin D deficiency: a systematic review and meta-analysis. — Loh HH, Lim LL, Yee A, Loh HS, Vethakkan SR Minerva endocrinologica (2019)
    13. [13]
      Primary hyperparathyroidism: Labs to order, Tx to consider. — Sanapureddy P, Garla VV, Pabbidi MR The Journal of family practice (2018)
    14. [14]
      Management of familial hyperparathyroidism syndromes: MEN1, MEN2, MEN4, HPT-Jaw tumour, Familial isolated hyperparathyroidism, FHH, and neonatal severe hyperparathyroidism. — Cristina EV, Alberto F Best practice & research. Clinical endocrinology & metabolism (2018)
    15. [15]
      MECHANISMS IN ENDOCRINOLOGY: Kidney involvement in patients with primary hyperparathyroidism: an update on clinical and molecular aspects. — Verdelli C, Corbetta S European journal of endocrinology (2017)
    16. [16]
      Feasibility and safety of minimally invasive radioguided parathyroidectomy using very low intraoperative dose of Tc-99m MIBI. — Mehrabibahar M, Mousavi Z, Sadeghi R, Layegh P, Nouri M, Asadi M International journal of surgery (London, England) (2017)
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      The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. — Wilhelm SM, Wang TS, Ruan DT, Lee JA, Asa SL, Duh QY et al. JAMA surgery (2016)
    18. [18]
      Musculoskeletal manifestations of primary hyperparathyroidism. — Pappu R, Jabbour SA, Reginato AM, Reginato AJ Clinical rheumatology (2016)
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      Should vitamin D deficiency be corrected before parathyroidectomy? — Randle RW, Balentine CJ, Wendt E, Schneider DF, Chen H, Sippel RS The Journal of surgical research (2016)
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      Primary hyperparathyroidism and vitamin D deficiency. — Vélayoudom-Céphise FL, Wémeau JL Annales d'endocrinologie (2015)
    21. [21]
      Techniques of parathyroid exploration at North American endocrine surgery fellowship programs: what the next generation is being taught. — Wang TS, Pasieka JL, Carty SE American journal of surgery (2014)
    22. [22]
      Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. — Eastell R, Brandi ML, Costa AG, D'Amour P, Shoback DM, Thakker RV The Journal of clinical endocrinology and metabolism (2014)
    23. [23]
      The surgical management of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. — Udelsman R, Åkerström G, Biagini C, Duh QY, Miccoli P, Niederle B et al. The Journal of clinical endocrinology and metabolism (2014)
    24. [24]
      Medical management of primary hyperparathyroidism: proceedings of the fourth International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism. — Marcocci C, Bollerslev J, Khan AA, Shoback DM The Journal of clinical endocrinology and metabolism (2014)
    25. [25]
      Current issues in the presentation of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. — Silverberg SJ, Clarke BL, Peacock M, Bandeira F, Boutroy S, Cusano NE et al. The Journal of clinical endocrinology and metabolism (2014)
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      Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. — Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C et al. The Journal of clinical endocrinology and metabolism (2014)
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      Multiple organ dysfunction caused by parathyroid adenoma-induced primary hyperparathyroidism. — Fu QY, Ma L, Yang ZB, Pao T Nigerian journal of clinical practice (2014)
    28. [28]
      The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice. — Aspinall SR, Nicholson S, Bliss RD, Lennard TW Annals of the Royal College of Surgeons of England (2012)
    29. [29]
      Diagnosis and management of primary hyperparathyroidism in Europe. — Langdahl BL, Ralston SH QJM : monthly journal of the Association of Physicians (2012)
    30. [30]
      Should 'mild primary hyperparathyroidism' be reclassified as 'insidious': is it time to reconsider? — Macfarlane DP, Yu N, Donnan PT, Leese GP Clinical endocrinology (2011)
    31. [31]
      Transient increases in intraoperative parathyroid levels related to anesthetic technique. — Hong JC, Morris LF, Park EJ, Ituarte PH, Lee CH, Yeh MW Surgery (2011)
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      Clinical significance of vitamin D deficiency in primary hyperparathyroidism, and safety of vitamin D therapy. — Mikhail N Southern medical journal (2011)
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      Primary hyperparathyroidism - is vitamin D supplementation safe? — Rankin W Australian family physician (2011)
    34. [34]
      Vanishing polyuria and respiratory failure. — Ruggieri F, Chiesa A, Schorn K, Strobel K, Maggiorini M, Schmid C BMJ case reports (2010)
    35. [35]
      Beneficial effect of endocrinologist-performed ultrasonography on preoperative parathyroid adenoma localization. — Akinci B, Demir T, Yener S, Comlekci A, Binicier O, Ozdogan O et al. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (2009)
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      Minimally invasive parathyroidectomy using local anesthesia with intravenous sedation and targeted approaches. — Shindo ML, Rosenthal JM, Lee T Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (2008)
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      Otolaryngologist-head and neck surgeon-performed ultrasonography for parathyroid adenoma localization. — Gurney TA, Orloff LA The Laryngoscope (2008)
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      Preoperative vitamin D replacement therapy in primary hyperparathyroidism: safe and beneficial? — Grubbs EG, Rafeeq S, Jimenez C, Feng L, Lee JE, Evans DB et al. Surgery (2008)
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      National survey on the management of primary hyperparathyroidism by Swiss endocrinologists. — Clerici T, Warschkow R, Triponez F, Brändle M Langenbeck's archives of surgery (2007)
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      Oral calcium supplementation associated with decreased likelihood of nephrolithiasis prior to surgery for hyperparathyroidism. — Cooperberg MR, Duh QY, Stackhouse GB, Stoller ML International journal of urology : official journal of the Japanese Urological Association (2007)
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      Minimally invasive radio-guided parathyroidectomy. — Rubello D, Giannini S, Martini C, Piotto A, Rampin L, Fanti S et al. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie (2006)
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      Third- or second-generation parathyroid hormone assays: a remaining debate in the diagnosis of primary hyperparathyroidism. — Boudou P, Ibrahim F, Cormier C, Chabas A, Sarfati E, Souberbielle JC The Journal of clinical endocrinology and metabolism (2005)
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      Significance of primary hyperparathyroidism in the management of osteoporosis. — Saleem TF, Horwith M, Stack BC Otolaryngologic clinics of North America (2004)
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      Minimally invasive parathyroidectomy with operative ultrasound localization of the adenoma. — Kell MR, Sweeney KJ, Moran CJ, Flanagan F, Kerin MJ, Gorey TF Surgical endoscopy (2004)
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      The impact of minimally invasive parathyroidectomy on the way endocrinologists treat primary hyperparathyroidism. — Gallagher SF, Denham DW, Murr MM, Norman JG Surgery (2003)
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      Clinical management of primary hyperparathyroidism and thresholds for surgical referral: a national study examining concordance between practice patterns and consensus panel recommendations. — Mahadevia PJ, Sosa JA, Levine MA, Zeiger MA, Powe NR Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (2003)
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      Rheumatic manifestations of primary hyperparathyroidism and parathyroid hormone therapy. — Rubin MR, Silverberg SJ Current rheumatology reports (2002)
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      Myxedema masking primary hyperparathyroidism. — Peter SA, Brignol YF Journal of the National Medical Association (1993)
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      Study of intact (1-84) parathyroid hormone secretion in patients undergoing parathyroidectomy. — Davies C, Demeure MJ, St John A, Edis AJ World journal of surgery (1990)
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      An 8-year-old patient with complicated primary hyperparathyroidism. — Stone WM, van Heerden JA, Zimmerman D Journal of pediatric surgery (1989)
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      Primary hyperparathyroidism in pregnancy. A report of two cases. — Higgins RV, Hisley JC The Journal of reproductive medicine (1988)
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      Acute pancreatitis and primary hyperparathyroidism in pregnancy: treatment of hypercalcemia with magnesium sulfate. — Rajala B, Abbasi RA, Hutchinson HT, Taylor T Obstetrics and gynecology (1987)
    54. [54]
      Primary hyperparathyroidism and hyperuricaemia are associated but not correlated with indicators of bone turnover. — Broulik PD, Stĕpán JJ, Pacovský V Clinica chimica acta; international journal of clinical chemistry (1987)
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      Binding of monoclonal antibody (4F2) to its cell surface antigen on dispersed adenomatous parathyroid cells raises cytosolic calcium and inhibits parathyroid hormone secretion. — Posillico JT, Srikanta S, Eisenbarth G, Quaranta V, Kajiji S, Brown EM The Journal of clinical endocrinology and metabolism (1987)
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      Parathyroid localization. — Gutekunst R, Valesky A, Borisch B, Hafermann W, Kiffner E, Thies E et al. The Journal of clinical endocrinology and metabolism (1986)
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      Ultrasonography in the localization of parathyroid adenomas. — Bennett JM, Steyn AF South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (1983)
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      Nephrolithiasis and hyperparathyroidism. — Broadus AE Hospital practice (Office ed.) (1982)
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      Pancreatitis associated with primary hyperparathyroidism. — Paloyan D, Simonowitz D, Paloyan E, Snyder TJ The American surgeon (1982)
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      Association between primary hyperparathyroidism and previous irradiation. — Tamura K, Shimaoka K, Spaulding S, Shedd D Journal of surgical oncology (1982)
    61. [61]
      The microscopical pathology of primary parathyroid hyperplasia. — Schantz A Annals of clinical and laboratory science (1979)
    62. [62]
      Transient metastatic calcification in primary hyperparathyroidism. — Cooper RA, Riley JW, Middleton WR, Wiseman JC, Hales IB Australian and New Zealand journal of medicine (1978)
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      Gray-scale echographic visualization of a parathyroid adenoma. — Crocker EF, Bautovich GJ, Jellins J Radiology (1978)
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      Presentation of primary hyperparathyroidism to a general medical unit. — Sheridan P Postgraduate medical journal (1978)
    65. [65]
      An unusual hormonal cause of hypertension and hypokalaemia. — Salant DJ, Rabkin R South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (1975)
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