{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:56:09Z","timestamp":1780581369873,"version":"3.54.1"},"reference-count":72,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Medical Clinics of North America"],"published-print":{"date-parts":[[2021,11]]},"DOI":"10.1016\/j.mcna.2021.05.017","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T16:26:51Z","timestamp":1631032011000},"page":"1135-1150","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluation and Management of Elevated Parathyroid Hormone Levels in Normocalcemic Patients"],"prefix":"10.1016","volume":"105","author":[{"given":"Natalie E.","family":"Cusano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"10","key":"10.1016\/j.mcna.2021.05.017_bib1","doi-asserted-by":"crossref","first-page":"3570","DOI":"10.1210\/jc.2014-1414","article-title":"Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the fourth international workshop","volume":"99","author":"Eastell","year":"2014","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"7","key":"10.1016\/j.mcna.2021.05.017_bib2","doi-asserted-by":"crossref","first-page":"2734","DOI":"10.1210\/jc.2013-1300","article-title":"Normocalcemic hyperparathyroidism and hypoparathyroidism in two community-based nonreferral populations","volume":"98","author":"Cusano","year":"2013","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"10\u201311","key":"10.1016\/j.mcna.2021.05.017_bib3","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.clinbiochem.2011.04.002","article-title":"Biochemical diagnosis of primary hyperparathyroidism: analysis of the sensitivity of total and ionized calcium in combination with PTH","volume":"44","author":"Nordenstr\u00f6m","year":"2011","journal-title":"Clin Biochem"},{"issue":"9","key":"10.1016\/j.mcna.2021.05.017_bib4","doi-asserted-by":"crossref","first-page":"3138","DOI":"10.1210\/jc.2012-1429","article-title":"The importance of measuring ionized calcium in characterizing calcium status and diagnosing primary hyperparathyroidism","volume":"97","author":"Ong","year":"2012","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib5","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.amjsurg.2019.10.032","article-title":"Comparative prospective study on the presentation of normocalcemic primary hyperparathyroidism. Is it more aggressive than the hypercalcemic form?","volume":"219","author":"G\u00f3mez-Ram\u00edrez","year":"2020","journal-title":"Am J Surg"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib6","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jocd.2012.12.001","article-title":"Normocalcemic Primary Hyperparathyroidism","volume":"16","author":"Cusano","year":"2013","journal-title":"J\u00a0Clin Densitom"},{"issue":"4","key":"10.1016\/j.mcna.2021.05.017_bib7","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1055\/a-0859-1020","article-title":"Normocalcemic primary hyperparathyroidism in adults without a history of nephrolithiasis or fractures: a prospective study","volume":"51","author":"Ros\u00e1rio","year":"2019","journal-title":"Horm Metab Res"},{"key":"10.1016\/j.mcna.2021.05.017_bib8","series-title":"Dietary reference intakes for calcium and vitamin D","year":"2011"},{"issue":"7","key":"10.1016\/j.mcna.2021.05.017_bib9","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1002\/jbmr.2536","article-title":"Serum 25-Hydroxyvitamin D levels: variability, knowledge gaps, and the concept of a desirable range","volume":"30","author":"Fuleihan Gel","year":"2015","journal-title":"J\u00a0Bone Miner Res"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib10","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1530\/EJE-13-0102","article-title":"Prevalence of subclinical contributors to low bone mineral density and\/or fragility fracture","volume":"169","author":"Eller-Vainicher","year":"2013","journal-title":"Eur J Endocrinol"},{"key":"10.1016\/j.mcna.2021.05.017_bib11","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S0272-6386(97)90330-9","article-title":"The importance of dietary calcium and phosphorous in the secondary hyperparathyroidism of patients with early renal failure","volume":"29","author":"Martinez","year":"1997","journal-title":"Am J Kidney Dis"},{"key":"10.1016\/j.mcna.2021.05.017_bib12","first-page":"S1","article-title":"KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)","year":"2009","journal-title":"Kidney Int Supplements"},{"issue":"9","key":"10.1016\/j.mcna.2021.05.017_bib13","first-page":"2844","article-title":"Alterations in parathyroid dynamics in lithium-treated subjects","volume":"82","author":"Haden","year":"1997","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib14","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1046\/j.1365-2796.2001.00868.x","article-title":"Effects of thiazide-and loop-diuretics, alone or in combination, on calcitropic hormones and biochemical bone markers: a randomized controlled study","volume":"250","author":"Rejnmark","year":"2001","journal-title":"J\u00a0Intern Med"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib15","doi-asserted-by":"crossref","first-page":"L27","DOI":"10.1210\/jc.2014-4065","article-title":"Letter to the Editor: thiazides are not inducers of PTH secretion: a comment on normocalcemic hyperparathyroidism","volume":"100","author":"Yacobi-Bach","year":"2015","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib16","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/S0002-9343(99)80134-X","article-title":"Alendronate treatment of the postmenopausal osteoporotic woman: effect of multiple dosages on bone mass and bone remodeling","volume":"99","author":"Chesnut","year":"1995","journal-title":"Am J Med"},{"issue":"10","key":"10.1016\/j.mcna.2021.05.017_bib17","doi-asserted-by":"crossref","first-page":"2266","DOI":"10.1111\/bcp.13332","article-title":"Effect of a single intravenous zoledronic acid administration on biomarkers of acute kidney injury (AKI) in patients with osteoporosis: a pilot study","volume":"83","author":"Cipriani","year":"2017","journal-title":"Br J Clin Pharmacol"},{"issue":"8","key":"10.1016\/j.mcna.2021.05.017_bib18","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1056\/NEJMoa044459","article-title":"Denosumab in postmenopausal women with low bone mineral density","volume":"354","author":"McClung","year":"2006","journal-title":"N\u00a0Engl J Med"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib19","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1172\/JCI107156","article-title":"Evidence for secondary hyperparathyroidism in idiopathic hypercalciuria","volume":"52","author":"Coe","year":"1973","journal-title":"J\u00a0Clin Invest"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib20","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.semnephrol.2008.01.005","article-title":"New insights into the pathogenesis of idiopathic hypercalciuria","volume":"28","author":"Worcester","year":"2008","journal-title":"Semin Nephrol"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib21","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.ando.2015.03.005","article-title":"How to manage an isolated elevated PTH?","volume":"76","author":"Souberbielle","year":"2015","journal-title":"Ann Endocrinol (Paris)"},{"issue":"4","key":"10.1016\/j.mcna.2021.05.017_bib22","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1210\/er.2001-0035","article-title":"Endocrinological disorders and celiac disease","volume":"23","author":"Collin","year":"2002","journal-title":"Endocr Rev"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib23","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1002\/jbm4.10019","article-title":"Serum calcium to phosphorous (Ca\/P) ratio is a simple, inexpensive, and accurate tool in the diagnosis of primary hyperparathyroidism","volume":"2","author":"Madeo","year":"2018","journal-title":"JBMR Plus"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib24","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s12020-020-02276-7","article-title":"The calcium-to-phosphorous (Ca\/P) ratio in the diagnosis of primary hyperparathyroidism and hypoparathyroidism: aa multicentric study","volume":"68","author":"Madeo","year":"2020","journal-title":"Endocrine"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib25","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12902-019-0487-8","article-title":"New parathyroid function index for the differentiation of primary and secondary hyperparathyroidism: a case-control study","volume":"20","author":"Guo","year":"2020","journal-title":"BMC Endocr Disord"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib26","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1172\/JCI100349","article-title":"Studies of calcium and phosphorus metabolism: XVIII. On temporary fluctuations in the level of calcium and inorganic phosphorus in blood serum of normal individuals","volume":"10","author":"Farquharson","year":"1931","journal-title":"J\u00a0Clin Invest"},{"issue":"6","key":"10.1016\/j.mcna.2021.05.017_bib27","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.beem.2018.09.009","article-title":"Management of normocalcemic primary hyperparathyroidism","volume":"32","author":"Cusano","year":"2018","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"10","key":"10.1016\/j.mcna.2021.05.017_bib28","doi-asserted-by":"crossref","first-page":"4641","DOI":"10.1210\/jc.2002-021404","article-title":"Normocalcemic primary hyperparathyroidism: evidence for a generalized target-tissue resistance to parathyroid hormone","volume":"88","author":"Maruani","year":"2003","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib29","first-page":"163","article-title":"Clinical expression of calcium sensing receptor polymorphism (A986S) in normocalcemic and asymptomatic hyperparathyroidism","volume":"48","author":"D\u00edaz-Soto","year":"2016","journal-title":"Horm Metab Res"},{"issue":"4","key":"10.1016\/j.mcna.2021.05.017_bib30","doi-asserted-by":"crossref","first-page":"e1171","DOI":"10.1210\/clinem\/dgaa084","article-title":"Normocalcemic hyperparathyroidism: study of its prevalence and natural history","volume":"105","author":"Schini","year":"2020","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"8","key":"10.1016\/j.mcna.2021.05.017_bib31","doi-asserted-by":"crossref","first-page":"e10391","DOI":"10.1002\/jbm4.10391","article-title":"Normocalcemic hyperparathyroidism: a heterogeneous disorder often misdiagnosed?","volume":"4","author":"Zavatta","year":"2020","journal-title":"JBMR Plus"},{"issue":"6","key":"10.1016\/j.mcna.2021.05.017_bib32","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1111\/cen.12732","article-title":"Normocalcaemic hypoparathyroidism: prevalence and effect on bone status in older women. The OPUS study","volume":"82","author":"Palermo","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib33","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1530\/EC-15-0030","article-title":"Normocalcemic primary hyperparathyroidism: a survey in a small village of Southern Italy","volume":"4","author":"Vignali","year":"2015","journal-title":"Endocr Connect"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib34","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/S0039-6060(97)90357-3","article-title":"Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women","volume":"121","author":"Lundgren","year":"1997","journal-title":"Surgery"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib35","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/cen.12819","article-title":"Normocalcaemic, vitamin D-sufficient hyperparathyroidism \u2013 high prevalence and low morbidity in the general population: A long-term follow-up study, the WHO MONICA project, Gothenburg, Sweden","volume":"83","author":"Kontogeorgos","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib36","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/cen.12569","article-title":"Characteristics of hyperparathyroid states in the Canadian multicentre osteoporosis study (CaMos) and relationship to skeletal markers","volume":"82","author":"Berger","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"key":"10.1016\/j.mcna.2021.05.017_bib37","first-page":"1","article-title":"Normocalcemic primary hyperparathyroidism: one-year follow-up in one hundred postmenopausal women","author":"Garc\u00eda-Mart\u00edn","year":"2012","journal-title":"Endocrine"},{"issue":"5","key":"10.1016\/j.mcna.2021.05.017_bib38","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1590\/S0004-27302011000500003","article-title":"Normocalcemic primary hyperparathyroidism in clinical practice: an indolent condition or a silent threat?","volume":"55","author":"Marques","year":"2011","journal-title":"Arq Bras Endocrinol Metabol"},{"issue":"8","key":"10.1016\/j.mcna.2021.05.017_bib39","doi-asserted-by":"crossref","first-page":"3001","DOI":"10.1210\/jc.2006-2802","article-title":"Normocalcemic primary hyperparathyroidism: further characterization of a new clinical phenotype","volume":"92","author":"Lowe","year":"2007","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"11","key":"10.1016\/j.mcna.2021.05.017_bib40","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1016\/j.amjmed.2004.06.037","article-title":"Characterization of normocalcemic primary hyperparathyroidism","volume":"117","author":"Tordjman","year":"2004","journal-title":"Am J Med"},{"key":"10.1016\/j.mcna.2021.05.017_bib41","first-page":"128352","article-title":"Normocalcemic versus hypercalcemic primary hyperparathyroidism: more stone than bone?","volume":"2012","author":"Amaral","year":"2012","journal-title":"J\u00a0Osteoporos"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib42","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s12020-012-9627-x","article-title":"Investigation of insulin resistance in patients with normocalcemic primary hyperparathyroidism","volume":"42","author":"Cakir","year":"2012","journal-title":"Endocrine"},{"issue":"4","key":"10.1016\/j.mcna.2021.05.017_bib43","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s00268-012-1438-y","article-title":"Surgical management of normocalcemic primary hyperparathyroidism","volume":"36","author":"Wade","year":"2012","journal-title":"World J Surg"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib44","doi-asserted-by":"crossref","first-page":"294","DOI":"10.4158\/EP15704.OR","article-title":"Primary hyperparathyroidism, with a focus on management of the normocalcemic form: to treat or not to treat?","volume":"22","author":"\u0160iprov\u00e1","year":"2016","journal-title":"Endocr Pract"},{"issue":"7","key":"10.1016\/j.mcna.2021.05.017_bib45","doi-asserted-by":"crossref","first-page":"dgaa174","DOI":"10.1210\/clinem\/dgaa174","article-title":"Clinical, biochemical, and radiological profile of normocalcemic primary hyperparathyroidism","volume":"105","author":"Palermo","year":"2020","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"10","key":"10.1016\/j.mcna.2021.05.017_bib46","doi-asserted-by":"crossref","first-page":"3580","DOI":"10.1210\/jc.2014-1415","article-title":"Current issues in the presentation of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop","volume":"99","author":"Silverberg","year":"2014","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib47","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1530\/eje.1.02173","article-title":"Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening","volume":"155","author":"Hagstr\u00f6m","year":"2006","journal-title":"Eur J Endocrinol"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib48","doi-asserted-by":"crossref","first-page":"23","DOI":"10.4158\/EP14195.OR","article-title":"Normocalcemic hyperparathyroidism and insulin resistance","volume":"21","author":"Temizkan","year":"2014","journal-title":"Endocr Pract"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib49","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1507\/endocrj.EJ15-0392","article-title":"Patients with normocalcemic primary hyperparathyroidism may have similar metabolic profile as hypercalcemic patients","volume":"63","author":"Yener Ozturk","year":"2016","journal-title":"Endocr J"},{"issue":"6","key":"10.1016\/j.mcna.2021.05.017_bib50","doi-asserted-by":"crossref","first-page":"2420","DOI":"10.1210\/jc.2014-4432","article-title":"Is normocalcemic primary hyperparathyroidism harmful or harmless?","volume":"100","author":"Chen","year":"2015","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"10.1016\/j.mcna.2021.05.017_bib51","doi-asserted-by":"crossref","first-page":"107985","DOI":"10.1016\/j.diabres.2019.107985","article-title":"Increased parathyroid hormone is associated with higher fasting glucose in individuals with normocalcemic primary hyperparathyroidism and prediabetes: a pilot study","volume":"160","author":"Karras","year":"2020","journal-title":"Diabetes Res Clin Pract"},{"issue":"5","key":"10.1016\/j.mcna.2021.05.017_bib52","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1530\/EJE-09-1067","article-title":"Cardiovascular risk factors and arterial rigidity are similar in asymptomatic normocalcemic and hypercalcemic primary hyperparathyroidism","volume":"162","author":"Tordjman","year":"2010","journal-title":"Eur J Endocrinol"},{"key":"10.1016\/j.mcna.2021.05.017_bib53","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2147\/VHRM.S128084","article-title":"Evaluation of coronary calcium score in patients with normocalcemic primary hyperparathyroidism","volume":"13","author":"Mesquita","year":"2017","journal-title":"Vasc Health Risk Management"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib54","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.surg.2019.05.094","article-title":"Coronary artery disease is more severe in patients with primaryhyperparathyroidism","volume":"167","author":"Koubaity","year":"2020","journal-title":"Surgery"},{"key":"10.1016\/j.mcna.2021.05.017_bib55","doi-asserted-by":"crossref","first-page":"115583","DOI":"10.1016\/j.bone.2020.115583","article-title":"Impaired physical function and evaluation of quality of life in normocalcemic and hypercalcemic primary hyperparathyroidism","volume":"141","author":"Voss","year":"2020","journal-title":"Bone"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib56","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1007\/s12020-014-0263-5","article-title":"Investigation of glucose intolerance in patients with normocalcemic primary hyperparathyroidism: 4-year follow-up","volume":"47","author":"Diri","year":"2014","journal-title":"Endocrine"},{"issue":"10","key":"10.1016\/j.mcna.2021.05.017_bib57","doi-asserted-by":"crossref","first-page":"3561","DOI":"10.1210\/jc.2014-1413","article-title":"Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop","volume":"99","author":"Bilezikian","year":"2014","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"7","key":"10.1016\/j.mcna.2021.05.017_bib58","doi-asserted-by":"crossref","first-page":"3319","DOI":"10.1210\/jc.2003-030908","article-title":"Alendronate in primary hyperparathyroidism: a double-blind, randomized, placebo-controlled trial","volume":"89","author":"Khan","year":"2004","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"7","key":"10.1016\/j.mcna.2021.05.017_bib59","doi-asserted-by":"crossref","first-page":"705","DOI":"10.4158\/EP08178.ORR","article-title":"Alendronate therapy in men with primary hyperparathyroidism","volume":"15","author":"Khan","year":"2009","journal-title":"Endocr Pract"},{"issue":"4","key":"10.1016\/j.mcna.2021.05.017_bib60","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1007\/s00198-014-3000-2","article-title":"Effects of alendronate and vitamin D in patients with normocalcemic primary hyperparathyroidism","volume":"26","author":"Cesareo","year":"2014","journal-title":"Osteoporos Int"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib61","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4081\/aiua.2015.1.66","article-title":"Use of cinacalcet in nephrolithiasis associated with normocalcemic or hypercalcemic primary hyperparathyroidism: results of a prospective randomized pilot study","volume":"87","author":"Brardi","year":"2015","journal-title":"Arch Ital Urol Androl"},{"issue":"8","key":"10.1016\/j.mcna.2021.05.017_bib62","doi-asserted-by":"crossref","first-page":"3213","DOI":"10.1210\/jc.2013-1518","article-title":"Bone mineral density evolution after successful parathyroidectomy in patients with normocalcemic primary hyperparathyroidism","volume":"98","author":"Koumakis","year":"2013","journal-title":"J\u00a0Clin Endocrinol Metab"},{"issue":"2","key":"10.1016\/j.mcna.2021.05.017_bib63","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1245\/s10434-018-6998-0","article-title":"Biochemical and skeletal outcomes of parathyroidectomy for normocalcemic (Incipient) primary hyperparathyroidism","volume":"26","author":"Sho","year":"2019","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib64","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s12872-019-1093-4","article-title":"Parathyroidectomy improves cardiovascular risk factors in normocalcemic and hypercalcemic primary hyperparathyroidism","volume":"19","author":"Beysel","year":"2019","journal-title":"BMC Cardiovasc Disord"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib65","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1002\/bjs.10739","article-title":"Effect of parathyroidectomy on quality of life and non-specific symptoms in normocalcaemic primary hyperparathyroidism","volume":"105","author":"Bannani","year":"2018","journal-title":"Br J Surg"},{"issue":"5","key":"10.1016\/j.mcna.2021.05.017_bib66","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/cen.14315","article-title":"Normocalcaemic primary hyperparathyroidism: an update on diagnostic and management challenges","volume":"93","author":"Dawood","year":"2020","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"10","key":"10.1016\/j.mcna.2021.05.017_bib67","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1007\/s00268-016-3514-1","article-title":"Outcomes of parathyroidectomy in patients with primary hyperparathyroidism: a systematic review and meta-analysis","volume":"40","author":"Singh Ospina","year":"2016","journal-title":"World J Surg"},{"issue":"3","key":"10.1016\/j.mcna.2021.05.017_bib68","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s00423-018-1659-0","article-title":"Is parathyroidectomy safe and effective in patients with normocalcemic primary hyperparathyroidism?","volume":"403","author":"Traini","year":"2018","journal-title":"Langenbecks Arch Surg"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib69","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.surg.2019.06.043","article-title":"Normocalcemic hyperparathyroidism: a collaborative endocrine surgery quality improvement program analysis","volume":"167","author":"Pandian","year":"2020","journal-title":"Surgery"},{"issue":"1","key":"10.1016\/j.mcna.2021.05.017_bib70","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.surg.2016.08.054","article-title":"Differences in single gland and multigland disease are seen in low biochemical profile primary hyperparathyroidism","volume":"161","author":"Lim","year":"2017","journal-title":"Surgery"},{"issue":"4","key":"10.1016\/j.mcna.2021.05.017_bib71","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1177\/0194599818793879","article-title":"Surgical management of normocalcemic primary hyperparathyroidism and the impact of intraoperative parathyroid hormone testing on outcome","volume":"159","author":"Trinh","year":"2018","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"4","key":"10.1016\/j.mcna.2021.05.017_bib72","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/1754-9485.12728","article-title":"Better performance of four-dimension computed tomography as a localization procedure in normocalcemic primary hyperparathyroidism","volume":"62","author":"Cunha-Bezerra","year":"2018","journal-title":"J\u00a0Med Imaging Radiat Oncol"}],"container-title":["Medical Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0025712521000869?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0025712521000869?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T01:45:34Z","timestamp":1758419134000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0025712521000869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":72,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["S0025712521000869"],"URL":"https:\/\/doi.org\/10.1016\/j.mcna.2021.05.017","relation":{},"ISSN":["0025-7125"],"issn-type":[{"value":"0025-7125","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Evaluation and Management of Elevated Parathyroid Hormone Levels in Normocalcemic Patients","name":"articletitle","label":"Article Title"},{"value":"Medical Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.mcna.2021.05.017","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}