De diagnostiek en behandeling van primaire hyperparathyreoïdie

Stand van zaken
Willemijn Y. van der Plas, Milou E. Noltes, Anouk W.M.A. Schaeffers, Adrienne H. Brouwers, Anouk N.A. van der Horst-Schrivers en Schelto Kruijff

Diagnostic approach and treatment of primary hyperparathyroidism

  • Primary hyperparathyroidism (PHPT) is characterised by elevated serum calcium levels due to elevated levels, or insufficient suppression, of parathyroid hormone (PTH).
  • The incidence of PHPT has increased in recent years. This is mainly the result of more frequently performed routine measurements of serum calcium, e.g. as part of postmenopausal screening.
  • The classically described features of PHPT – bones and stones – are not always observed and most patients are asymptomatic.
  • Diagnosis of PHPT is only established by biochemical testing, not by imaging.
  • Ultrasound and technetium-99m sestamibi SPECT-CT are the first-choice imaging modalities. These investigations are necessary to localize the parathyroid adenomas and thereby facilitate minimal invasive parathyroidectomy (MIP).

Conflict of interest and financial support: none declared.