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Diagnosis and Treatment |

The Medical Management of Primary Hyperparathyroidism

JOHN P. BILEZIKIAN, M.D.
[+] Article and Author Information

Grant support: Dr. Bilezikian is the recipient of Research Career Development Award HL 00383 from the National Institutes of Health. Some of the data cited were obtained through support from grant RR 00645 from the National Institutes of Health.

▸Requests for reprints should be addressed to John P. Bilezikian, M.D.; Department of Medicine 8-405, College of Physicians and Surgeons, 630 West 168th Street; New York, NY 10032.


New York, New York


© 1982 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1982;96(2):198-202. doi:10.7326/0003-4819-96-2-198
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Primary hyperparathyroidism has become a relatively common endocrine disorder. Greater recognition of this disease has led to earlier detection. Consequently, primary hyperparathyroidism is now characterized frequently by asymptomatic mild hypercalcemia rather than by the more classical presentation with bone or renal involvement. Patients who have hypercalcemia and signs or symptoms should undergo neck surgery and removal of the abnormal parathyroid tissue. For the growing population of asymptomatic patients, however, indications for surgery are not as clear. The natural history of primary hyperparathyroidism is variable, and predicting who will develop complications of this disorder is not possible. Alternatives to surgery are careful and regular observation combined with various general and specific approaches currently receiving attention. Available information on the medical management of asymptomatic, mild primary hyperparathyroidism is summarized.

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