Hiperparatiroidismo primario

Primary hyperparathyroidism (PHPT) is an endocrine disease resulting from hyperfunction of one or more parathyroid glands (80% and 15-20% of cases, respectively) and is characterized by the presence of hypercalcemia associated with elevated or inappropriately normal parathyroid hormone (PTH) levels. Currently, PHPT is mainly an asymptomatic condition; therefore, it should be actively sought in the presence of nephrolithiasis, hypercalciuria, osteoporosis, or fractures in order to achieve appropriate management. During the diagnostic process, other conditions that present with elevated PTH levels, as well as other causes of hypercalcemia (such as familial hypocalciuric hipercalcemia or lithium use) must be excluded. Definitive treatment is surgical and involves preoperative imaging localization of parathyroid glands. Patients who do not qualify for surgery may opt for medical therapy. This paper reviews current epidemiological, pathophysiological, clinical, diagnostic, and therapeutic aspects of PHPT.