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This milder biochemical entity remains incompletely understood because of a lack of long\u2010term health outcomes regarding both medical and surgical approaches to its management. Medical therapies have shown some efficacy. A limited number of studies have found that bisphosphonates increase bone mineral density, and calcimimetics may decrease the risk of nephrolithiasis in patients with normocalcaemic primary hyperparathyroidism. Studies have also described patient outcomes after applying the same surgical criteria used for patients with hypercalcaemic primary hyperparathyroidism to those with the normocalcaemic form of the disease. These studies suggest that parathyroid surgery appears to be effective in normalizing elevated serum parathyroid hormone concentrations and decreasing adverse renal and skeletal outcomes in patients with normocalcaemic hyperparathyroidism. Given the available data and overall lack of consensus regarding the optimal management of these patients, a reasonable approach is to tailor treatment to the individual patient by considering their risk factors for new or accelerated bone loss, kidney stones, diminished quality of life, and cardiovascular disease.<\/jats:p>","DOI":"10.1111\/cen.14315","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T11:27:57Z","timestamp":1598614077000},"page":"519-527","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Normocalcaemic primary hyperparathyroidism: An update on diagnostic and management challenges"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1762-6144","authenticated-orcid":false,"given":"Nardeen B.","family":"Dawood","sequence":"first","affiliation":[{"name":"UCLA David Geffen School of Medicine Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly L.","family":"Yan","sequence":"additional","affiliation":[{"name":"UCLA David Geffen School of Medicine Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Shieh","sequence":"additional","affiliation":[{"name":"Division of Medicine Geriatric Medicine UCLA David Geffen School of Medicine Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masha J.","family":"Livhits","sequence":"additional","affiliation":[{"name":"Section of Endocrine Surgery Department of Surgery UCLA David Geffen School of Medicine Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Section of Endocrine Surgery Department of Surgery UCLA David Geffen School of Medicine Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8935-9332","authenticated-orcid":false,"given":"Angela M.","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism Department of Medicine UCLA David Geffen School of Medicine Los Angeles CA USA"},{"name":"Division of Endocrinology, Diabetes, and Metabolism Department of Medicine VA Greater Los Angeles Healthcare System Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-4022"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-1300"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-012-9694-z"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(97)90357-3"},{"issue":"04","key":"e_1_2_8_6_1","first-page":"243","article-title":"Normocalcemic primary hyperparathyroidism in adults without a history of nephrolithiasis or fractures. 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