{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:10:21Z","timestamp":1778281821512,"version":"3.51.4"},"reference-count":120,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Primary hyperparathyroidism is an endocrine disorder characterized by chronic\n                    hypercalcaemia resulting from the unregulated excessive production of\n                    parathyroid hormone. This study aimed mainly to determine the clinical\n                    manifestations of primary hyperparathyroidism within the African population.\n                    This study was a systematic review carried out in strict compliance with the\n                    Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.\n                    The meta-analysis was executed utilizing Meta XL version 5.3, applying the\n                    DerSimonian Laird random-effects model. A total of 52 studies met the\n                    eligibility criteria, resulting in an overall sample size of 2,807 patients. The\n                    average age was 55.1 years. Seventy-nine percentage of the patients were women.\n                    Asymptomatic individuals represented 26% of the population. The most common\n                    symptoms include bone pain, lethargy, and features related to renal stones.\n                    Familial primary hyperparathyroidism is observed in 6% of patients. The majority\n                    of individuals diagnosed with primary hyperparathyroidism are women in their\n                    sixth decade. In contrast to developed countries, a considerable number of\n                    Africans suffering from primary hyperparathyroidism have already shown symptoms,\n                    which are frequently non-specific or have encountered complications before\n                    obtaining a diagnosis.<\/jats:p>","DOI":"10.1055\/a-2820-3666","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T23:39:53Z","timestamp":1773877193000},"page":"199-209","source":"Crossref","is-referenced-by-count":1,"title":["Primary Hyperparathyroidism in Africa: A Systematic Review and\n                    Meta-Analysis of Clinical Manifestations"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3982-5790","authenticated-orcid":false,"given":"Taoreed Adegoke","family":"Azeez","sequence":"additional","affiliation":[{"name":"Acute Medicine, Hull University Teaching Hospitals NHS\n                    Trust, Hull, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oyindamola","family":"Awofisoye","sequence":"additional","affiliation":[{"name":"Medicine, Mid Cheshire Hospitals NHS Foundation Trust,\n                    Crewe, United Kingdom of Great Britain and Northern Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olapeju Oluwafunmilayo","family":"Adeyemi","sequence":"additional","affiliation":[{"name":"Medicine, University College Hospital Ibadan, Ibadan,\n                    Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1016\/j.surg.2014.08.004","article-title":"Hyperparathyroidism-jaw tumor syndrome: Results of operative management","volume":"156","author":"A 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utilization of parathyroidectomy among patients with\n                    primary hyperparathyroidism: Evidence from a nationwide analysis of medicare\n                    claims","volume":"171","author":"W M Alobuia","year":"2022","journal-title":"Surgery"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic\n                    reviews","volume":"372","author":"M J Page","year":"2021","journal-title":"BMJ"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/01.NOR.0000330315.06351.13","article-title":"Agency for healthcare research and quality (AHRQ) web site","volume":"27","author":"E Carlson","year":"2008","journal-title":"Orthop Nurs Natl Assoc Orthop Nurs"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"e14138","DOI":"10.1111\/jep.14138","article-title":"Mastering meta-analysis in microsoft excel with 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Salem","year":"2006","journal-title":"Isot Radiat Res"},{"key":"ref24","first-page":"20","volume-title":"Treatment and follow up of primary hyperparathyroidism: 50 cases","author":"H Cheikhrouhou","year":"2006"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/j.1475-097X.2011.01048.x","article-title":"Correlation between serum calcium levels and dual-phase 99mTc-sestamibi\n                    parathyroid scintigraphy in primary hyperparathyroidism","volume":"32","author":"D S Mshelia","year":"2012","journal-title":"Clin Physiol Funct Imaging"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s10330-011-0866-8","article-title":"Surgical management of primary hyperparathyroidism guided by double-phase\n                    Tc-99m-MIBI scintigraphy","volume":"11","author":"AH H Ezzat","year":"2012","journal-title":"Chin -Ger J Clin Oncol"},{"key":"ref27","first-page":"P267","volume-title":"Vitamin D status 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Bouzid","year":"2021"},{"issue":"02","key":"ref43","first-page":"101","article-title":"Ethiopian medical journal","volume":"59","author":"M Tbini","year":"2021","journal-title":"Ethiop Med J"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"102929","DOI":"10.1016\/j.amsu.2021.102929","article-title":"Comparative analysis of clinicopathologic features between adenoma and\n                    hyperplasia in surgically treated patients for hyperparathyroidism: A\n                    retrospective study","volume":"71","author":"B Efared","year":"2021","journal-title":"Ann Med Surg"},{"issue":"04","key":"ref45","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1016\/j.ekir.2021.03.098","article-title":"POS-090 primary hyperparatyhroidism: A nephrologist experience","volume":"6","author":"N B Mahmoud","year":"2021","journal-title":"Kidney Int Rep"},{"issue":"01","key":"ref46","first-page":"16","article-title":"Bone health in patients undergoing surgery for primary hyperparathyroidism at\n                    tygerberg hospital, Cape Town, South Africa","volume":"26","author":"M Budge","year":"2021","journal-title":"J Endocrinol Metab Diabetes S Afr"},{"key":"ref47","first-page":"EP167","volume-title":"Classical complications of primary hyperparathyroidism","author":"L Zarraa","year":"2022"},{"key":"ref48","volume-title":"Particularities of primary hyperparathyroidism in multiple endocrine neoplasia\n                    type 1: Tunisian data","author":"M Fatma","year":"2022"},{"key":"ref49","first-page":"104751","article-title":"Diagnostic and therapeutic determinants in parathyroid surgery: A retrospective\n                    cohort study","volume":"82","author":"A A Sbai","year":"2022","journal-title":"Ann Med Surg (Lond)"},{"issue":"02","key":"ref50","first-page":"60","article-title":"Factors associated with severe hypercalcemia in patients with primary\n                    hyperparathyroidism","volume":"79","author":"M Yazidi","year":"2022","journal-title":"\u041f\u0440\u043e\u0431\u043b\u0435\u043c\u0438 \u0435\u043d\u0434\u043e\u043a\u0440\u0438\u043d\u043d\u043e\u0457 \u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0456\u0457"},{"issue":"06","key":"ref51","doi-asserted-by":"crossref","first-page":"e380","DOI":"10.1002\/edm2.380","article-title":"Management of severe hypercalcaemia secondary to primary hyperparathyroidism:\n                    The efficacy of saline hydration, furosemide, and zoledronic acid","volume":"5","author":"I Oueslati","year":"2022","journal-title":"Endocrinol Diabetes Metab"},{"key":"ref52","first-page":"P323","volume-title":"Epidemiologic, clinical and biological aspects of primary hyperparathyroidism:\n                    About 107 cases","author":"A S Mohamed","year":"2023"},{"issue":"04","key":"ref53","first-page":"427","article-title":"Primary hyperparathyroidia at the abass ndao hospital center: About 29\n                    cases","volume":"13","author":"D Di\u00e9dhiou","year":"2023","journal-title":"Open J Int Med"},{"key":"ref54","first-page":"P594","volume-title":"The clinical and etiological aspects of primary hyperparathyroidism","author":"B Myriam","year":"2023"},{"key":"ref55","first-page":"EP180","volume-title":"Vitamin D in primary hyperparathyroidism: status and its effects on primary\n                    hyperparathyroidism","author":"R El Amel","year":"2023"},{"key":"ref56","first-page":"P50","volume-title":"Impact of the Covid19 pandemic on patients with primary hyperparathyroidism","author":"SC B Hadj","year":"2023"},{"key":"ref57","doi-asserted-by":"crossref","DOI":"10.1530\/endoabs.90.P46","volume-title":"Cardiovascular aspects of primary hyperparathyroidism","author":"B Myriam","year":"2023"},{"key":"ref58","first-page":"P595","volume-title":"Therapeutic and evolutive aspects of primary hyperparathyroidism","author":"BH S Chayma","year":"2023"},{"key":"ref59","first-page":"EP483","volume-title":"Assessment of vitamin d status in patients with primary hyperparathyroidism:\n                    implications for clinical management","author":"G Khaoula","year":"2024"},{"issue":"01","key":"ref60","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s12902-024-01583-8","article-title":"Characteristics, management and outcomes of primary hyperparathyroidism from\n                    2009 to 2021: A single centre report from South Africa","volume":"24","author":"K Govind","year":"2024","journal-title":"BMC Endocr Disord"},{"key":"ref61","first-page":"E162","volume-title":"Exploring complications associated with primary hyperparathyroidism: findings\n                    from an 83-case study","author":"G Khaoula","year":"2024"},{"issue":"25","key":"ref62","doi-asserted-by":"crossref","first-page":"1","DOI":"10.21608\/ejentas.2022.174289.1577","article-title":"Parathyroid carcinoma and recurrent hyperparathyroidm: Challenges and management\n                    options","volume":"25","author":"TE F Abdelrahman","year":"2024","journal-title":"Egypt J Ear Nose Throat Allied Sci"},{"issue":"01","key":"ref63","first-page":"6","article-title":"99mTc-Mibi parathyroid scintigraphy in the exploration of\n                    hyperparathyroidism in Senegal: A study of 66 cases in the idrissa pouye general\n                    hospital, Dakar","volume":"12","author":"Thiaw G Bathily EHAL","year":"2024","journal-title":"Eur J Biophys"},{"key":"ref64","first-page":"1265364","article-title":"Recurrent urolithiasis revealing primary hyperparathyroidism in a nephrology\n                    department","volume":"2024","author":"H Meriam","year":"2024","journal-title":"Case Rep Nephrol"},{"issue":"05","key":"ref65","first-page":"472","article-title":"Impact of surgery on sleep quality in patients with primary\n                    hyperparathyroidism","volume":"85","author":"C Ben Ammar","year":"2024","journal-title":"Annales 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(Lausanne)"},{"issue":"02","key":"ref71","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/NJM.NJM_22_25","article-title":"Deficiency of clinical trials on endocrine disorders: perspectives from\n                    sub-saharan Africa","volume":"34","author":"T A Azeez","year":"2025","journal-title":"Niger J Med"},{"issue":"09","key":"ref72","doi-asserted-by":"crossref","first-page":"e828","DOI":"10.1634\/theoncologist.2018-0424","article-title":"Failure to diagnose and treat hyperparathyroidism among patients with\n                    hypercalcemia: Opportunities for intervention at the patient and physician level\n                    to increase surgical referral","volume":"24","author":"A Asban","year":"2019","journal-title":"Oncologist"},{"key":"ref73","doi-asserted-by":"crossref","first-page":"395","DOI":"10.2147\/IJGM.S223882","article-title":"Identifying key challenges facing healthcare systems in africa and potential\n                    solutions","volume":"12","author":"O O Oleribe","year":"2019","journal-title":"Int J Gen Med"},{"issue":"01","key":"ref74","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s12961-021-00778-y","article-title":"Measuring health science research and development in Africa: mapping the\n                    available data","volume":"19","author":"C Wenham","year":"2021","journal-title":"Health Res Policy Syst"},{"issue":"01","key":"ref75","doi-asserted-by":"crossref","first-page":"e70040","DOI":"10.1002\/puh2.70040","article-title":"Understanding health inequality, disparity and inequity in Africa: A rapid\n                    review of concepts, root causes, and strategic solutions","volume":"4","author":"G I Oke","year":"2025","journal-title":"Public Health Chall"},{"key":"ref76","doi-asserted-by":"crossref","first-page":"103118","DOI":"10.1016\/j.apgeog.2023.103118","article-title":"Estimating geographic access to healthcare facilities in sub-saharan africa by\n                    degree of urbanisation","volume":"160","author":"P Florio","year":"2023","journal-title":"Appl Geogr"},{"issue":"10","key":"ref77","doi-asserted-by":"crossref","first-page":"e1922","DOI":"10.1210\/clinem\/dgae326","article-title":"Skeletal effect of parathyroidectomy on patients with primary\n                    hyperparathyroidism: A systematic review and meta-analysis","volume":"109","author":"N Kongsaree","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"issue":"04","key":"ref78","doi-asserted-by":"crossref","first-page":"IJE22","DOI":"10.2217\/ije-2019-0005","article-title":"Primary hyperparathyroidism: A retrospective study over 18 years in an oncology\n                    center","volume":"6","author":"A C Martins","year":"2019","journal-title":"Int J Endocr Oncol"},{"key":"ref79","first-page":"100317","article-title":"Symptomatic versus asymptomatic primary hyperparathyroidism: A systematic review\n                    and meta-analysis","volume":"32","author":"P Kulkarni","year":"2023","journal-title":"J Clin Transl Endocrinol"},{"key":"ref80","doi-asserted-by":"crossref","first-page":"117130","DOI":"10.1016\/j.bone.2024.117130","article-title":"Association between primary hyperparathyroidism and cardiovascular outcomes: A\n                    systematic review and meta-analysis","volume":"185","author":"S K Kong","year":"2024","journal-title":"Bone"},{"issue":"06","key":"ref81","doi-asserted-by":"crossref","first-page":"e2215396","DOI":"10.1001\/jamanetworkopen.2022.15396","article-title":"Analysis of comorbidities, clinical outcomes, and parathyroidectomy in adults\n                    with primary hyperparathyroidism","volume":"5","author":"K F Axelsson","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"01","key":"ref82","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/s00268-021-06331-w","article-title":"Parathyroid hormone disturbances in postmenopausal women with distal forearm\n                    fracture","volume":"46","author":"A Wihlborg","year":"2022","journal-title":"World J Surg"},{"issue":"02","key":"ref83","doi-asserted-by":"crossref","first-page":"101980","DOI":"10.1016\/j.beem.2025.101980","article-title":"Changing trends in clinical presentation of primary hyperparathyroidism across\n                    countries over time","volume":"39","author":"D Arjunan","year":"2025","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"20","key":"ref84","doi-asserted-by":"crossref","first-page":"7398","DOI":"10.3390\/jcm14207398","article-title":"Duration of menopause, rather than primary hyperparathyroidism severity,\n                    predicts osteoporosis in postmenopausal women: A pilot study from a spanish\n                    reference center","volume":"14","author":"A Arana","year":"2025","journal-title":"J Clin Med"},{"issue":"01","key":"ref85","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/00016340601033287","article-title":"Primary hyperparathyroidism is common in postmenopausal women with forearm\n                    fracture and low bone mineral density","volume":"86","author":"I Bergstr\u00f6m","year":"2007","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"03","key":"ref86","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1007\/s12020-023-03476-7","article-title":"Genetic aspects underlying the normocalcemic and hypercalcemic phenotypes of\n                    primary hyperparathyroidism","volume":"82","author":"A Viviani","year":"2023","journal-title":"Endocrine"},{"issue":"11","key":"ref87","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1530\/EC-21-0382","article-title":"Changes in clinical patterns of Chinese patients with primary\n                    hyperparathyroidism in the past 12 years: A single-center experience","volume":"10","author":"Y Liu","year":"2021","journal-title":"Endocr Connect"},{"issue":"11","key":"ref88","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1007\/s40618-018-0879-z","article-title":"Clinical presentation and management of patients with primary\n                    hyperparathyroidism in Italy","volume":"41","author":"F Saponaro","year":"2018","journal-title":"J Endocrinol Invest"},{"issue":"01","key":"ref89","doi-asserted-by":"crossref","first-page":"366","DOI":"10.21037\/apm-22-1171","article-title":"Changes in the pathophysiology of primary hyperparathyroidism and analysis of\n                    postoperative recurrence cases at a regional core hospital in Japan: experience\n                    of 35 years in Shinshu University Hospital","volume":"12","author":"T Kanai","year":"2023","journal-title":"Ann Palliative Med"},{"key":"ref90","doi-asserted-by":"crossref","first-page":"bvae163.388","DOI":"10.1210\/jendso\/bvae163.388","article-title":"8032 clinical and laboratory characteristics of patients with primary\n                    hyperparathyroidism followed at a Brazilian university hospital","volume":"8","author":"G Koga","year":"2024","journal-title":"J Endocr Soc"},{"issue":"02","key":"ref91","doi-asserted-by":"crossref","first-page":"101980","DOI":"10.1016\/j.beem.2025.101980","article-title":"Changing trends in clinical presentation of primary hyperparathyroidism across\n                    countries over time","volume":"39","author":"D Arjunan","year":"2025","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"01","key":"ref92","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1159\/000505497","article-title":"Symptoms of primary hyperparathyroidism in men and women: The same but\n                    different?","volume":"36","author":"T Weber","year":"2020","journal-title":"Visc Med"},{"issue":"01","key":"ref93","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1186\/s12902-022-01059-7","article-title":"Primary hyperparathyroidism in Saudi Arabia revisited: a multi-centre\n                    observational study","volume":"22","author":"Y Al-Saleh","year":"2022","journal-title":"BMC Endocr Disord"},{"issue":"01","key":"ref94","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/ijem.ijem_468_24","article-title":"Primary hyperparathyroidism: Clinical, biochemical, and radio-pathological\n                    profiles of 804 patients \u2013 A retrospective study from South India","volume":"29","author":"D Sadacharan","year":"2025","journal-title":"Indian J Endocrinol Metab"},{"issue":"21","key":"ref95","doi-asserted-by":"crossref","first-page":"11639","DOI":"10.3390\/ijms252111639","article-title":"Bone disease in primary hyperparathyroidism\u2014changes occurring in bone metabolism\n                    and new potential treatment strategies","volume":"25","author":"M Iwanowska","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref96","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jss.2021.01.029","article-title":"Tired of being ignored: Fatigue as a presenting symptom in primary\n                    hyperparathyroidism","volume":"263","author":"K B Montgomery","year":"2021","journal-title":"J Surg Res"},{"issue":"04","key":"ref97","doi-asserted-by":"crossref","first-page":"256","DOI":"10.5114\/reum\/170705","article-title":"Primary hyperparathyroidism: Clinical manifestations, diagnosis and evaluation\n                    according to the fifth international workshop guidelines","volume":"61","author":"M Kochman","year":"2023","journal-title":"Reumatologia"},{"key":"ref98","doi-asserted-by":"crossref","first-page":"A199","DOI":"10.1210\/jendso\/bvac150.410","article-title":"PSAT167 Asian-Indians with symptomatic primary hyperparathyroidism have lower\n                    body weight at presentation and tend to gain weight post-curative\n                    parathyroidectomy","volume":"6","author":"R Pal","year":"2022","journal-title":"J Endocr Soc"},{"issue":"03","key":"ref99","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.amjsurg.2009.08.024","article-title":"Influence of morbid obesity on parathyroidectomy outcomes in primary\n                    hyperparathyroidism","volume":"199","author":"S C Pitt","year":"2010","journal-title":"Am J Surg"},{"issue":"06","key":"ref100","first-page":"1065","article-title":"Parathyroid diseases and metabolic syndrome","volume":"46","author":"R Modica","year":"2023","journal-title":"J Endocrinol Invest"},{"issue":"06","key":"ref101","doi-asserted-by":"crossref","first-page":"e28333","DOI":"10.1016\/j.heliyon.2024.e28333","article-title":"Unusual body weight loss due to primary hyperparathyroidism: A case study with\n                    literature review","volume":"10","author":"Y Y Lin","year":"2024","journal-title":"Heliyon"},{"issue":"02","key":"ref102","first-page":"105","article-title":"Primary hyperparathyroidism in developing world: a systematic review on the\n                    changing clinical profile of the disease","volume":"64","author":"S K Yadav","year":"2020","journal-title":"Arch Endocrinol Metab"},{"issue":"08","key":"ref103","doi-asserted-by":"crossref","first-page":"167","DOI":"10.31083\/j.fbl2808167","article-title":"Role of parathyroid hormone and parathyroid hormone-related protein in\n                    protein-energy malnutrition","volume":"28","author":"P Srisuwarn","year":"2023","journal-title":"Front Biosci (Landmark Ed)"},{"issue":"06","key":"ref104","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1210\/jc.2008-1965","article-title":"Acute pancreatitis in primary hyperparathyroidism: A population-based study","volume":"94","author":"T K Khoo","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"06","key":"ref105","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1111\/j.1440-1746.2007.05050.x","article-title":"Chronic pancreatitis in primary hyperparathyroidism: comparison with alcoholic\n                    and idiopathic chronic pancreatitis","volume":"23","author":"S K Bhadada","year":"2008","journal-title":"J Gastroenterol Hepatol"},{"issue":"06","key":"ref106","doi-asserted-by":"crossref","first-page":"721","DOI":"10.4103\/ijmr.IJMR_353_16","article-title":"Frequency & predictors of pancreatitis in symptomatic primary\n                    hyperparathyroidism","volume":"148","author":"A K Arya","year":"2018","journal-title":"Indian J Med Res"},{"issue":"04","key":"ref107","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4292\/wjgpt.v13.i4.47","article-title":"Primary hyperparathyroidism presenting as acute pancreatitis: An institutional\n                    experience with review of the literature","volume":"13","author":"K G Rashmi","year":"2022","journal-title":"World J Gastrointest Pharmacol Ther"},{"issue":"06","key":"ref108","doi-asserted-by":"crossref","first-page":"513","DOI":"10.4103\/ijem.ijem_169_23","article-title":"PHPT with pancreatitis: Atypical presentation of PHPT","volume":"27","author":"Y Devgan","year":"2023","journal-title":"Indian J Endocrinol Metab"},{"issue":"17","key":"ref109","doi-asserted-by":"crossref","first-page":"100741","DOI":"10.12998\/wjcc.v13.i17.100741","article-title":"Recurrent acute pancreatitis and primary hyperparathyroidism in patients\n                    presenting to the emergency department: Diagnostic challenges","volume":"13","author":"F Dan\u0131\u015f","year":"2025","journal-title":"World J Clin Cases"},{"issue":"04","key":"ref110","first-page":"87816","article-title":"Acute pancreatitis secondary to primary hyperparathyroidism","volume":"2","author":"RA A Castellanos","year":"2023","journal-title":"J Brown Hosp Med"},{"issue":"16","key":"ref111","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.12998\/wjcc.v7.i16.2367","article-title":"Acute pancreatitis connected with hypercalcemia crisis in hyperparathyroidism: A\n                    case report","volume":"7","author":"Y B Ma","year":"2019","journal-title":"World J Clin Cases"},{"key":"ref112","doi-asserted-by":"crossref","first-page":"623667","DOI":"10.3389\/fendo.2021.623667","article-title":"Familial Hyperparathyroidism","volume":"12","author":"J E Blau","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"04","key":"ref113","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.ecl.2021.08.003","article-title":"Hereditary primary hyperparathyroidism","volume":"50","author":"P J Newey","year":"2021","journal-title":"Endocrinol Metab Clin North Am"},{"key":"ref114","doi-asserted-by":"crossref","first-page":"834362","DOI":"10.3389\/fendo.2022.834362","article-title":"Genetics and Epigenetics of parathyroid carcinoma","volume":"13","author":"F Marini","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"05","key":"ref115","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1210\/endrev\/bnad009","article-title":"Molecular and clinical spectrum of primary hyperparathyroidism","volume":"44","author":"S Jha","year":"2023","journal-title":"Endocr Rev"},{"issue":"01","key":"ref116","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s42000-023-00508-9","article-title":"Genetics of hereditary forms of primary hyperparathyroidism","volume":"23","author":"K A English","year":"2024","journal-title":"Hormones (Athens)"},{"issue":"21","key":"ref117","doi-asserted-by":"crossref","first-page":"6718","DOI":"10.3390\/jcm12216718","article-title":"Primary hyperparathyroidism and cardiovascular disease: An association study\n                    using clinical natural language processing systems and big data analytics","volume":"12","author":"P 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