{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:04:50Z","timestamp":1792037090504,"version":"4.4.0"},"reference-count":118,"publisher":"The Endocrine Society","issue":"11","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["DK32333"],"award-info":[{"award-number":["DK32333"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary hyperparathyroidism (PHPT), the most common cause of hypercalcemia, is most often identified in postmenopausal women. The clinical presentation of PHPT has evolved over the past 40 years to include three distinct clinical phenotypes, each of which has been studied in detail and has led to evolving concepts about target organ involvement, natural history, and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the present review, I provide an evidence-based summary of this disorder as it has been studied worldwide, citing key concepts and data that have helped to shape our concepts about this disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PHPT is now recognized to include three clinical phenotypes: overt target organ involvement, mild asymptomatic hypercalcemia, and high PTH levels with persistently normal albumin-corrected and ionized serum calcium values. The factors that determine which of these clinical presentations is more likely to predominate in a given country include the extent to which biochemical screening is used, vitamin D deficiency is present, and whether parathyroid hormone levels are routinely measured in the evaluation of low bone density or frank osteoporosis. Guidelines for parathyroidectomy apply to all three clinical forms of the disease. If surgical guidelines are not met, parathyroidectomy can also be an appropriate option if no medical contraindications are present. If either the serum calcium or bone mineral density is of concern and surgery is not an option, pharmacological approaches are available and effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Advances in our knowledge of PHPT have guided new concepts in diagnosis and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jc.2018-01225","type":"journal-article","created":{"date-parts":[[2018,7,27]],"date-time":"2018-07-27T14:12:11Z","timestamp":1532700731000},"page":"3993-4004","source":"Crossref","is-referenced-by-count":298,"title":["Primary Hyperparathyroidism"],"prefix":"10.1210","volume":"103","author":[{"given":"John P","family":"Bilezikian","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,7,27]]},"reference":[{"issue":"8","key":"2020071622565589100_B1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1210\/jcem-8-8-637","article-title":"A page out of the history of hyperparathyroidism","volume":"8","author":"Albright","year":"1948","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071622565589100_B2","doi-asserted-by":"crossref","first-page":"593","DOI":"10.7326\/0003-4819-114-7-593","article-title":"Diagnosis and management of asymptomatic primary hyperparathyroidism","volume":"114","author":"Consensus Development Conference Panel","year":"1991","journal-title":"Ann Intern Med"},{"key":"2020071622565589100_B3","first-page":"N2","article-title":"Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century","volume":"17","author":"Bilezikian","year":"2002","journal-title":"J Bone Miner Res"},{"issue":"2","key":"2020071622565589100_B4","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1210\/jc.2008-1763","article-title":"Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop","volume":"94","author":"Bilezikian","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"2020071622565589100_B5","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"},{"issue":"16","key":"2020071622565589100_B6","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":"2020071622565589100_B7","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/B978-0-12-397166-1.00007-2","volume-title":"The Parathyroids","author":"Revollo","year":"2015","edition":"3rd ed."},{"key":"2020071622565589100_B8","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/B978-0-12-397166-1.00008-4","volume-title":"The Parathyroids","author":"Silva","year":"2015","edition":"3rd ed."},{"issue":"6","key":"2020071622565589100_B9","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1210\/jc.2015-3907","article-title":"Management of hypoparathyroidism: summary statement and guidelines","volume":"101","author":"Brandi","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"10116","key":"2020071622565589100_B10","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/S0140-6736(17)31430-7","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian","year":"2018","journal-title":"Lancet"},{"key":"2020071622565589100_B11","doi-asserted-by":"crossref","first-page":"16033","DOI":"10.1038\/nrdp.2016.33","article-title":"Primary hyperparathyroidism","volume":"2","author":"Bilezikian","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"2020071622565589100_B12","unstructured":"Bilezikian JP. 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