{"title":"Chapter 2: Primary Hyperparathyroidism: diagnosis","authors":"Benjamin Bouillet , Jean-Philippe Bertocchio , Claire Nominé-Criqui , Véronique Kerlan","doi":"10.1016/j.ando.2025.101691","DOIUrl":null,"url":null,"abstract":"<div><div>Primary hyperparathyroidism is now predominantly an asymptomatic pathology, as blood calcium assay has become systematic. Diagnosis therefore requires screening for target organ damage when this is not already indicative of primary hyperparathyroidism. Classical clinical manifestations include bone, kidney and muscle signs, and are characterized by reversibility after parathyroid surgery. Their presence requires blood calcium assay. Non-classical manifestations include cardiovascular, digestive and neuropsychological signs, which are not known to be reversible after surgery. Positive diagnosis is biological, based on a parathyroid hormone value that is inappropriate to the blood calcium value. The typical form combines hypercalcemia, elevated parathyroid hormone and increased calciuria or calcium excretion fraction. Atypical forms combine either hypercalcemia and normal parathyroid hormone level, or normal calcemia with increased parathyroid hormone level, not necessarily secondary to another cause, such as 25(OH) vitamin D deficiency. The oral calcium loading test and the Pro-FHH score are contributive to diagnosis in atypical forms.</div></div>","PeriodicalId":7917,"journal":{"name":"Annales d'endocrinologie","volume":"86 1","pages":"Article 101691"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annales d'endocrinologie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0003426625000101","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Primary hyperparathyroidism is now predominantly an asymptomatic pathology, as blood calcium assay has become systematic. Diagnosis therefore requires screening for target organ damage when this is not already indicative of primary hyperparathyroidism. Classical clinical manifestations include bone, kidney and muscle signs, and are characterized by reversibility after parathyroid surgery. Their presence requires blood calcium assay. Non-classical manifestations include cardiovascular, digestive and neuropsychological signs, which are not known to be reversible after surgery. Positive diagnosis is biological, based on a parathyroid hormone value that is inappropriate to the blood calcium value. The typical form combines hypercalcemia, elevated parathyroid hormone and increased calciuria or calcium excretion fraction. Atypical forms combine either hypercalcemia and normal parathyroid hormone level, or normal calcemia with increased parathyroid hormone level, not necessarily secondary to another cause, such as 25(OH) vitamin D deficiency. The oral calcium loading test and the Pro-FHH score are contributive to diagnosis in atypical forms.
期刊介绍:
The Annales d''Endocrinologie, mouthpiece of the French Society of Endocrinology (SFE), publishes reviews, articles and case reports coming from clinical, therapeutic and fundamental research in endocrinology and metabolic diseases. Every year, it carries a position paper by a work-group of French-language endocrinologists, on an endocrine pathology chosen by the Society''s Scientific Committee. The journal is also the organ of the Society''s annual Congress, publishing a summary of the symposia, presentations and posters. "Les Must de l''Endocrinologie" is a special booklet brought out for the Congress, with summary articles that are always very well received. And finally, we publish the high-level instructional courses delivered during the Henri-Pierre Klotz International Endocrinology Days. The Annales is a window on the world, keeping alert clinicians up to date on what is going on in diagnosis and treatment in all the areas of our specialty.