Primary Hyperparathyroidism

A condition of abnormally elevated output of PARATHYROID HORMONE due to parathyroid HYPERPLASIA or PARATHYROID NEOPLASMS. It is characterized by the combination of HYPERCALCEMIA, phosphaturia, elevated renal 1,25-DIHYDROXYVITAMIN D3 synthesis, and increased BONE RESORPTION.

Also Known As:

Networked: 3073 relevant articles (125 outcomes, 312 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Parathyroid Neoplasms (Parathyroid Neoplasm)
2.	Hypercalcemia (Milk Alkali Syndrome)
3.	Multiple Endocrine Neoplasia Type 1 (MEN I)
4.	Neoplasms (Cancer)
5.	Osteoporosis

Experts

1.	Chen, Herbert: 39 articles (10/2015 - 08/2002)
2.	Sippel, Rebecca S: 26 articles (10/2015 - 01/2004)
3.	Bilezikian, John P: 20 articles (11/2014 - 10/2003)
4.	Silverberg, Shonni J: 19 articles (12/2015 - 04/2002)
5.	Perrier, Nancy D: 17 articles (06/2014 - 06/2003)
6.	Duh, Quan-Yang: 16 articles (01/2014 - 08/2003)
7.	Irvin, George L: 16 articles (12/2011 - 08/2002)
8.	Udelsman, Robert: 14 articles (11/2014 - 05/2002)
9.	Solorzano, Carmen C: 14 articles (03/2011 - 12/2003)
10.	Lew, John I: 13 articles (12/2015 - 07/2006)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Primary Hyperparathyroidism:

1.	CalciumIBA 11/01/2006 - "Intraoperative total calcium levels may help to predict adequate elimination of parathyroid tissue in primary hyperparathyroidism when intraoperative iPTH is not available. " 04/01/1983 - "Of 500 consecutive patients who underwent cervical exploration for presumed primary hyperparathyroidism, 461 (92.2 per cent) were cured, as judged by an immediate return of serum calcium levels to normal. " 01/01/2013 - "We attempted to study the incidence of TP in patients with primary hyperparathyroidism (PHPT) and correlate with calcium levels, scintigraphy and histopathology findings. " 07/01/2011 - "This study was to establish biochemical thresholds for the intravenous calcium suppression test in the early diagnosis of primary hyperparathyroidism (PHPT). " 01/01/2011 - "The study provides evidence for the efficiency of calcium screening in primary hyperparathyroidism and shows the feasibility of involving endocrine surgery in the course of orthopaedic treatment."
2.	Parathyroid Hormone (Parathormone)IBA 06/01/1993 - "The introduction of assays for the intact parathyrin (parathyroid hormone) has dramatically improved the diagnosis and follow-up of patients with primary hyperparathyroidism. " 02/25/1995 - "To evaluate the efficacy of rapid peroperative assay of parathormone in patients with primary hyperparathyroidism compared with the longer standard assay. " 12/01/2007 - "Measurement of qPTH (based solely on the criterion of greater than 50% decline of parathyroid hormone) in 72 patients with primary hyperparathyroidism (77 procedures) showed true-positive results in 69, false-positive results in 4, and true-negative results in 4 procedures. " 02/01/2009 - "The aim of our study was to evaluate the efficacy of Tc(99m) sestamibi preoperative imaging, intraoperative Tc(99m) sestamibi with gamma probe, and intraoperative parathyroid hormone (IOPTH) assessment in a large cohort of patients with primary hyperparathyroidism. " 10/01/2003 - "We conclude that the PTH (1-84)-IRMA offers improved diagnostic sensitivity in patients with primary hyperparathyroidism than other currently available assays. "
3.	cinacalcet (Sensipar)FDA Link 01/01/2006 - "Clinical studies performed in primary hyperparathyroidism proved AMG 073 to be effective in reducing both PTH and Ca serum levels, with a good safety profile. " 06/01/2011 - "Cinacalcet is effective in controlling the biochemical abnormalities in patients with primary hyperparathyroidism (PHPT) but it seems to be less effective on bone mineral density (BMD). " 12/01/2014 - "The PRIMARA study: a prospective, descriptive, observational study to review cinacalcet use in patients with primary hyperparathyroidism in clinical practice." 12/01/2009 - "Cinacalcet treatment of primary hyperparathyroidism: biochemical and bone densitometric outcomes in a five-year study." 12/01/2003 - "In this randomized, double-blind, dose-finding study, patients (n = 22) with primary hyperparathyroidism were given cinacalcet (30, 40, or 50 mg) or placebo twice daily for 15 d and observed for an additional 7 d. "
4.	Technetium Tc 99m Sestamibi (Cardiolite)FDA LinkGeneric 06/01/1997 - "Technetium 99m sestamibi was recently introduced for the preoperative localization of abnormal parathyroid glands in patients with primary hyperparathyroidism with promising results. " 05/01/2005 - "This study was planned to investigate the efficacy of either 99mTc-sestamibi scan or ultrasonography in predicting the operative treatment in patients with primary hyperparathyroidism (PHPT). " 03/01/2002 - "A prospective study was performed to evaluate the efficacy of technetium-99m-sestamibi and technetium-99m-pertechnetate subtraction scanning and US for imaging parathyroid glands in primary hyperparathyroidism. " 01/01/2013 - "The objective of this study was to assess the utility of ultrasonography (US) and technetium-99m-sestamibi (MIBI) scans in locating ectopic parathyroid glands in previously unexplored patients who presented with primary hyperparathyroidism. " 02/01/2005 - "Radioguided surgery of primary hyperparathyroidism using the low-dose 99mTc-sestamibi protocol: multiinstitutional experience from the Italian Study Group on Radioguided Surgery and Immunoscintigraphy (GISCRIS)."
5.	Vitamin DFDA LinkGeneric 01/01/2011 - "Vitamin D status, physical performance and body mass in patients surgically cured for primary hyperparathyroidism compared with healthy controls - a cross-sectional study." 12/01/2007 - "Temporally associated with the improvement in vitamin D nutrition in many Western countries in the mid-20th century, there was a change in many characteristics of primary hyperparathyroidism. " 02/01/2015 - "Health-related quality of life after successful surgery for primary hyperparathyroidism: no additive effect from vitamin D supplementation: results of a double-blind randomized study." 03/01/2014 - "Vitamin D treatment in primary hyperparathyroidism: a randomized placebo controlled trial." 12/01/2015 - "Low vitamin D levels have become less common in primary hyperparathyroidism."
6.	DiphosphonatesIBA 07/03/1995 - "The newer bisphosphonates show great promise in the treatment of Paget's disease, while surgery remains the only treatment option in primary hyperparathyroidism." 07/01/1977 - "This preliminary study indicates a possible role of diphosphonates in the management of inoperable cases of primary hyperparathyroidism or pseudohyperparathyroidism." 01/01/2011 - "Surgical indications and approach will be reviewed as well as medical management of primary hyperparathyroidism with bisphosphonates and calcimimetics." 12/01/2007 - "Recently, accumulating evidence indicates that treatment with oral bisphosphonates increases bone mineral density in patients with mild primary hyperparathyroidism, although it is yet uncertain whether it also prevents fracture." 12/01/2004 - "Patients with primary hyperparathyroidism (pHPT) are sometimes treated with bisphosphonates (BPs) as an alternative to surgery despite sparse documentation of the efficacy in this disorder. "
7.	Sodium Pertechnetate Tc 99m (Pertechnetate)FDA Link 09/01/2001 - "The main purposes of this study were: (a) to investigate the efficacy of an imaging protocol based on the combination of 99mTcO4/MIBI scintigraphy and neck ultrasound (US) in selecting patients with primary hyperparathyroidism (HPT) for unilateral neck exploration, and (b) to help define the role of the intraoperative MIBI gamma probe (IMGP) technique in the performance of minimally invasive radio-guided surgery (MIRS). " 09/01/2000 - "The aims of this study were: (a) to define the accuracy of a preoperative parathyroid imaging protocol based on the combination of technetium-99m pertechnetate/technetium-99m methoxyisobutylisonitrile (99mTcO4/ 99mTc-MIBI) scan and neck ultrasound (US) in selecting patients with primary hyperparathyroidism (pHPT) eligible for a limited neck exploration, and (b) to investigate the potential role of the intraoperative gamma probe (IGP) in radio-guided minimally invasive surgery. " 12/12/1992 - "The aim of this study was to evaluate the use of scintigraphy with thallium-201 chloride (201 Tl) and technetium-99m pertechnetate (99mTc) in the diagnosis of the localization of the pathological parathyroid glands in primary hyperparathyroidism and compare the results with those of high resolution ultrasonography. " 07/01/2014 - "Comparison of Tc-99m pertechnetate images with dual-phase Tc 99m MIBI and SPECT images in primary hyperparathyroidism." 03/01/2008 - "A combination of planar 99mTc-MIBI/99mTcO4- scintigraphy and P-SPECT appears to be a highly accurate preoperative imaging procedure in primary hyperparathyroidism."
8.	hydroxide ionIBA 12/01/2005 - "The objective of the study was to clarify whether 1,25(OH)2D indeed inhibits circulating levels of PTH and influences bone turnover, even in a patient with primary hyperparathyroidism. " 04/01/1986 - "This study was designed to follow the evolution of serum 1,25(OH)2D after surgery for primary hyperparathyroidism. " 09/01/2015 - "Seasonal variability in 25(OH)D and PTH levels has also been reported in primary hyperparathyroidism (PHPT). " 06/01/2012 - "PTH thresholds, providing 95% specificities for primary hyperparathyroidism diagnosis, were 7.6 pmol/l and 5.8 pmol/l, using ROC curves derived from 25(OH)D deplete or replete controls, respectively. " 05/01/2011 - "In healthy subjects and in patients with primary hyperparathyroidism (PH), the administration of a low dose of 25(OH)D (25 μg/day) increases the serum levels of both 25(OH)D and 1,25(OH)(2)D. "
9.	25-hydroxyvitamin DIBA 12/01/1999 - "This study was performed to determine the prevalence in the United States of low 25-hydroxyvitamin D levels among patients with mild primary hyperparathyroidism, and the effect of 25-hydroxyvitamin D status on disease severity. " 08/01/2006 - "Primary hyperparathyroidism (PHPT) is associated with reduced plasma 25-hydroxyvitamin D (P-25OHD) and usually increased plasma 1alpha,25-dihydroxyvitamin D (P-1,25(OH)2D). " 03/01/2014 - "Low 25-hydroxyvitamin D levels are common in patients with primary hyperparathyroidism (PHPT) and associated with higher PTH levels and hungry bone syndrome after parathyroidectomy (PTX). " 12/01/1987 - "2. The elimination half-time of 25-hydroxyvitamin D was significantly shortened in primary hyperparathyroidism and reverted towards normal after parathyroidectomy. " 02/01/2014 - "Association between serum 25-hydroxyvitamin D level and subclinical cardiovascular disease in primary hyperparathyroidism."
10.	HormonesIBA 12/01/1989 - "Although variability in individual expression of the rhythm for PTH precludes precise definition of a sampling "window" when hormone levels are likely to be highest, collection of data at points throughout the day helped establish the diagnosis of primary hyperparathyroidism in several patients with borderline serum biochemistries." 02/01/2000 - "Plasma levels of this hormone may be normal or elevated in patients with primary hyperparathyroidism. " 01/01/1994 - "The reaction of adenohypophysis hormones in primary hyperparathyroidism and after surgical treatment." 09/01/1989 - "Serum PTH levels have been more often observed to be elevated in individuals with primary hyperparathyroidism with the use of research quality radioimmunoassays that recognize both inactive fragments and intact hormone than with conventional N-terminal or intact assays. " 05/01/1988 - "[Critical analysis of 2 segment-specific radioimmunoassays for the measurement of parathyroid hormones in the diagnosis of primary hyperparathyroidism]."

Therapies and Procedures

1.	Parathyroidectomy 09/01/2014 - "Minimally invasive parathyroidectomy is successful in achieving cure for most patients with primary hyperparathyroidism. " 06/01/2010 - "Additional imaging with neck ultrasonography is helpful for selecting minimally invasive parathyroidectomy in most patients with primary hyperparathyroidism who have negative sestamibi scan results. " 11/01/2008 - "Targeted parathyroidectomy, when appropriately selected and carried out, is an effective treatment of primary hyperparathyroidism in most cases. " 12/01/2006 - "Controversy exists concerning the best treatment for asymptomatic primary hyperparathyroidism (PHPT) when the National Institutes of Health consensus conference criteria for parathyroidectomy are not met. " 09/01/2004 - "Although bilateral exploration is highly effective in the treatment of primary hyperparathyroidism, minimally invasive parathyroidectomy has evolved into the procedure of choice when a single parathyroid lesion can be localized preoperatively. "
2.	Hormone Replacement Therapy (Therapy, Hormone Replacement) 09/01/2000 - "Hormone replacement therapy in postmenopausal women with primary hyperparathyroidism has also been effective in improving bone mineral density and decreasing bone turnover. " 07/24/2000 - "Effects of hormone replacement therapy on bone mineral density in postmenopausal women with primary hyperparathyroidism: four-year follow-up and comparison with healthy postmenopausal women." 04/01/2000 - "These results lend experimental support that hormone replacement therapy may benefit bone health in postmenopausal women with primary hyperparathyroidism (PHPT). " 09/01/1996 - "Effect of hormone replacement therapy on bone mineral density in postmenopausal women with mild primary hyperparathyroidism. " 07/24/2000 - "Hormone replacement therapy is efficacious in the long-term management of osteopenia in postmenopausal women with primary hyperparathyroidism and thus represents an important new therapeutic option for asymptomatic patients who do not have other indications for surgery. "
3.	Anesthesia 03/01/2011 - "Outpatient MIP, employing image-directed focused exploration under cervical block anesthesia, has replaced traditional surgical approaches for many patients with primary hyperparathyroidism. " 10/01/2008 - "Outcome data were collected on patients with primary hyperparathyroidism whom we intended to treat with MIRP at the induction of anesthesia between October 1, 2005, and December 31, 2007. " 05/01/2002 - "Traditional surgery for primary hyperparathyroidism (HPTH) involves bilateral cervical exploration, which is usually accomplished under general endotracheal anesthesia. " 06/01/1991 - "We review the anesthesia used on patients with primary hyperparathyroidism from 1980-1989. " 06/01/1991 - "Anesthesia for primary hyperparathyroidism."
4.	Sternotomy 09/01/2010 - "Fifty-one upper mediastinal exploration by a conventional cervicotomy, 12 by video-assisted approaches (two thoracoscopy and 10 transcervical mediastinoscopy) and six by sternotomy were performed in 63 patients with primary hyperparathyroidism. " 04/01/2005 - "Inframanubrial parathyroid glands in patients with primary hyperparathyroidism: alternatives to sternotomy." 01/01/1989 - "Sternotomies performed for the treatment of primary hyperparathyroidism are unsuccessful in one third of patients. " 10/01/1985 - "Median sternotomy in reoperations for primary hyperparathyroidism." 10/01/1983 - "Of 26 patients evaluated at UCLA Medical Center for persistent primary hyperparathyroidism, six required sternotomy (5) or thoracotomy (1) for cure of their disease. "
5.	Local Anesthesia 04/01/2006 - "RMIP under local anesthesia is a safe and effective modality to treat primary hyperparathyroidism. " 06/01/2008 - "This experience has enabled us to achieve the current concept of surgical treatment for primary hyperparathyroidism, particularly with the development of minimally invasive techniques performed under local anesthesia. " 12/01/1999 - "Two hundred thirty-six patients underwent BNE under local anesthesia for primary hyperparathyroidism that was performed by a single surgeon between 1988 and April 1999. " 12/01/1999 - "Unilateral neck exploration under local anesthesia: the approach of choice for asymptomatic primary hyperparathyroidism." 03/01/1999 - "In a consecutive series of 121 initial cervicotomies for primary hyperparathyroidism performed between 1995 and 1997, 31 patients were selected on the basis of their own request to undergo a conventional bilateral neck exploration under local anesthesia and hypnosedation. "