Department of Primary Care and Medicine, G.V. (Sonny) Montgomery VA Medical Center, Jackson, Miss (Dr. Sanapureddy); University of Mississippi Medical Center, Jackson, Miss (Drs. Garla and Pabbidi) sanapureddypadmaja@gmail.com
The authors reported no potential conflict of interest relevant to this article.
Although largely asymptomatic, consider PHPT when patients present with unexplained kidney stones, osteoporosis, or any nonspecific symptoms described earlier. PHPT is diagnosed by detecting an inappropriately high or normal PTH in relation to the Ca2+ level. Medications need to be reviewed, and conditions such as FHH that produce similar symptoms need to be ruled out. Measurement of 25(OH) vitamin D levels is recommended in all patients with PHPT.
Parathyroidectomy is the definitive form of treatment and should be offered to patients who meet any one of the surgical criteria, as described earlier. It can also be offered to patients who do not meet the criteria if they prefer. It is known to decrease the risk of kidney stones and osteoporosis. Medical therapy is primarily for patients who do not meet the criteria as mentioned earlier and for those who cannot and/or are unwilling to undergo surgery.
CORRESPONDENCE Padmaja Sanapureddy, MD, Department of Primary Care and Medicine, G.V. (Sonny) Montgomery VA Medical Center, 1500 E Woodrow Wilson Ave, Jackson, MS 39216; sanapureddypadmaja@gmail.com.
