{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T22:54:56Z","timestamp":1772578496383,"version":"3.50.1"},"reference-count":159,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n            <jats:title>Purpose of review<\/jats:title>\n            <jats:p>The purpose of this review is to describe recent advances and changes in the evaluation and management of primary hyperparathyroidism (PHPT).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Recent findings<\/jats:title>\n            <jats:p>Although it has long been recognized that asymptomatic PHPT is associated with bone loss, particularly at cortical skeletal sites when evaluated with dual-energy X-ray absorptiometry, new imaging techniques suggest that trabecular skeletal deterioration as well as clinically silent vertebral fractures and nephrolithiasis are common. Nonclassical targets of asymptomatic PHPT as well as the effect of vitamin D deficiency and treatment upon PHPT presentation have been the subject of recent intense investigation. Randomized clinical trials are now available regarding the effect of parathyroidectomy (PTX) upon both classical and nonclassical target organs. They have confirmed results from observational studies with regard to the skeletal benefits of PTX but have not consistently shown improvements in nonclassical symptoms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Summary<\/jats:title>\n            <jats:p>These findings have led to recommendations for more extensive renal and skeletal evaluation and broader criteria for PTX in PHPT. In addition to dual-energy X-ray absorptiometry, vertebral and renal imaging is recommended. When available, trabecular imaging techniques may be helpful. PTX criteria now include subclinical kidney stones, vertebral fractures and hypercalciuria, in addition to those based on age, serum calcium, bone densitometry and renal function.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bor.0000000000000511","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T21:02:35Z","timestamp":1523998955000},"page":"427-439","source":"Crossref","is-referenced-by-count":26,"title":["Primary hyperparathyroidism: recent advances"],"prefix":"10.1097","volume":"30","author":[{"given":"Marcella D.","family":"Walker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Bilezikian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20230829","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"R2-20230829","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1056\/NEJM196605262742105","article-title":"The study of hyperparathyroidism at the Massachusetts General Hospital","volume":"274","author":"Cope","year":"1966","journal-title":"N Engl J Med"},{"key":"R3-20230829","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1001\/jama.1934.02750160010003","article-title":"Hyperparathyroidism: common and polymorphic condition as illustrated by seventeen proven cases in one clinic","volume":"102","author":"Albright","year":"1934","journal-title":"JAMA"},{"key":"R4-20230829","doi-asserted-by":"crossref","first-page":"2837","DOI":"10.1007\/s00198-015-3199-6","article-title":"Low vitamin D levels have become less common in primary hyperparathyroidism","volume":"26","author":"Walker","year":"2015","journal-title":"Osteoporos Int"},{"key":"R5-20230829","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 Clin Endocrinol Metab"},{"key":"R6-20230829","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1210\/jc.2014-3708","article-title":"Prevalence of kidney stones and vertebral fractures in primary hyperparathyroidism using imaging technology","volume":"100","author":"Cipriani","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"R7-20230829","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1210\/jc.2006-1836","article-title":"Medical observation, compared with parathyroidectomy, for asymptomatic primary hyperparathyroidism: a prospective, randomized trial","volume":"92","author":"Bollerslev","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"R8-20230829","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1210\/jc.2012-4022","article-title":"Incidence and prevalence of primary hyperparathyroidism in a racially mixed population","volume":"98","author":"Yeh","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"R9-20230829","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1359\/JBMR.050910","article-title":"Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993\u20132001: an update on the changing epidemiology of the disease","volume":"21","author":"Wermers","year":"2006","journal-title":"J Bone Miner Res"},{"key":"R10-20230829","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/j.surg.2013.06.051","article-title":"The prevalence of undiagnosed and unrecognized primary hyperparathyroidism: a population-based analysis from the electronic medical record","volume":"154","author":"Press","year":"2013","journal-title":"Surgery"},{"key":"R11-20230829","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1056\/NEJM198001243020402","article-title":"Primary hyperparathyroidism. 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