{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:25:54Z","timestamp":1785342354095,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T00:00:00Z","timestamp":1517443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Normocalcemic (NCpHPT) and normohormonal (NHpHPT) variants have been recognized primary hyperparathyroidism entities that pose serious challenges. We sought to define the differences among them in a series of surgically treated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Between 2011 and 2015, 149 patients were enrolled into three groups: CpHPT (Ca &gt; 10.2\u00a0mg\/dL, PTH &gt; 65 pg\/mL), NCpHPT (normal Ca, PTH &gt; 65 pg\/mL) and NHpHPT (Ca &gt; 10.2\u00a0mg\/dL, normal PTH). Descriptive statistics and inter\u2010group differences were computed, whereas multiple logistic\/linear regression tests were used for further analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of these patients 125 were female and 24\u00a0male, mean age 56.3 years (range 8\u201383). A total of 115 (77.2%) patients presented with CpHPT, 23 (15.4%) with NCpHPT and 11 (7.4%) with NHpHPT. MGD was found in 25 (16.8%) patients and SGD in 124 (83.2%); multivariate analysis failed to reveal statistically significant association of MGD with any pHPT variant (CpHPT 16.5% vs NCpHPT 21.7% vs NHpHPT 9.1%, <jats:italic>p<\/jats:italic> = 0.726). Conversely, NCpHPT patients exhibited statistically significant smaller adenoma weight (<jats:italic>p<\/jats:italic> = 0.023). Moreover, U\/S in these patients had smaller positive predictive value (<jats:italic>p<\/jats:italic> = 0.278), whereas concordance between U\/S and MIBI was also lower (<jats:italic>p<\/jats:italic> = 0.669). The utility of MIBI and U\/S differed significantly (<jats:italic>p<\/jats:italic> &lt; 0.001); more frequent use of U\/S was observed for all groups. However, their predictive values did not differ significantly (<jats:italic>p<\/jats:italic> = 0.832).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NCpHPT is more similar than different to CpHPT. NCpHPT constitutes the most challenging entity: it is associated with smaller adenoma weight, whereas U\/S exhibited lower positive predictive value and lower concordance rate with MIBI. A trend for higher MGD presence in this group of patients was observed, though without statistical significance.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4512-2","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T18:56:35Z","timestamp":1517511395000},"page":"992-997","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Classic Primary Hyperparathyroidism Versus Normocalcemic and Normohormonal Variants: Do They Really Differ?"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4774-777X","authenticated-orcid":false,"given":"Andreas","family":"Kiriakopoulos","sequence":"first","affiliation":[{"name":"Department of Surgery, 5th Surgical Clinic, Evgenidion Hospital National and Kapodistrian University of Athens Medical School Papadiamantopoulou 20 Str. 11528 Athens 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