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Endocrine Abstracts (2022) 81 S4.1 | DOI: 10.1530/endoabs.81.S4.1

ECE2022 Symposia Parathyroid disorders clinical update (PARAT group) (3 abstracts)

Management of primary hyperparathyroidism (PHPT)

Neil Gittoes


Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom


The European PARAT group have recently explored a number of practical management issues in parathyroid diseases. Herein, we present expert opinion on areas of controversy in the diagnosis and management of primary hyperparathyroidism (PHPT). Although PHPT is common, its differential diagnosis from familial hypocalciuric hypercalcaemia (FHH) poses practical problems. Proposed approaches to addressing this will be discussed. The definition and clinical course of normocalcemic PHPT remains controversial and there is particular emphasis on excluding causes of secondary hyperparathyroidism that can cause elevated PTH with normal blood calcium levels. An algorithm is presented to explore the approach to diagnosing normocalcaemic PHPT. Recurrent PHPT is rare but requires clear definition and approaches to reassessment and redo surgery should be performed at centres with great expertise in repeat surgery. Per- and post-operative management of patients with PHPT differs from centre to centre. We propose a structured approach to patient preparation for parathyroidectomy and review causes and management of post-operative hypocalcaemia. Longer term follow up and assessment of PHPT patients is also discussed. The recommendations on clinical management presented herein serve as background for further educational material aimed at a broad clinical audience and were developed with the focus on endocrinologists in training.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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