Hyperparathyroidism secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo parathyroidectomy. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing parathyroidectomy. | Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo [[parathyroidectomy]]. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing [[parathyroidectomy]]. Effective measures for secondary prevention of secondary hyperparathyroidism include maintain adequate [[nutrition]], proper intake of [[vitamin D]] and/or sufficient sunlight exposure, and adequate [[physical activity]]. Effective measures for secondary prevention of tertiary hyperparathyroidism include early detection and treatment of hyperparathyroidism by either calcimimetics or [[parathyroidectomy]]. | ||
==Secondary Prevention== | ==Secondary Prevention== | ||
Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo parathyroidectomy. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing parathyroidectomy. These guidelines include:<ref name="pmid25162665">{{cite journal| author=Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C et al.| title=Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. | journal=J Clin Endocrinol Metab | year= 2014 | volume= 99 | issue= 10 | pages= 3561-9 | pmid=25162665 | doi=10.1210/jc.2014-1413 | pmc=5393490 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25162665 }}</ref> | * Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo [[parathyroidectomy]]. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing [[parathyroidectomy]]. These guidelines include:<ref name="pmid25162665">{{cite journal| author=Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C et al.| title=Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. | journal=J Clin Endocrinol Metab | year= 2014 | volume= 99 | issue= 10 | pages= 3561-9 | pmid=25162665 | doi=10.1210/jc.2014-1413 | pmc=5393490 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25162665 }}</ref> | ||
*'''Serum calcium''' | **'''Serum calcium''' | ||
**Serum [[calcium]] should be monitored annually. | ***Serum [[calcium]] should be monitored annually. | ||
*'''Skeletal monitoring''' | **'''Skeletal monitoring''' | ||
**[[Dual energy X-ray absorptiometry|Dual-energy X-ray absorptiometry]] ([[Dual energy X-ray absorptiometry|DEXA]]) is used for [[Skeleton|skeletal]] monitoring. [[DEXA scan|DEXA]] should be done every 1-2 years (at 3 sites). | ***[[Dual energy X-ray absorptiometry|Dual-energy X-ray absorptiometry]] ([[Dual energy X-ray absorptiometry|DEXA]]) is used for [[Skeleton|skeletal]] monitoring. [[DEXA scan|DEXA]] should be done every 1-2 years (at 3 sites). | ||
**X-ray or vertebral fracture assessment of [[spine]] may be done if indications are present such as height loss, and/or back pain. | ***X-ray or [[vertebral fracture]] assessment of [[spine]] may be done if indications are present such as height loss, and/or [[back pain]]. | ||
*'''Renal monitoring''' | **'''Renal monitoring''' | ||
**Estimated [[glomerular filtration rate]] (eGFR) and [[serum creatinine]] should be done annually. | ***Estimated [[glomerular filtration rate]] (eGFR) and [[serum creatinine]] should be done annually. | ||
**24-hour [[biochemical]] [[Kidney stone|stone]] profile, [[Kidney|renal]] imaging by [[X-rays|x-ray]], [[ultrasound]], or [[CT scan]] may be considered if [[Kidney stone|renal stones]] are suspected. | ***24-hour [[biochemical]] [[Kidney stone|stone]] profile, [[Kidney|renal]] imaging by [[X-rays|x-ray]], [[ultrasound]], or [[CT scan]] may be considered if [[Kidney stone|renal stones]] are suspected. | ||
* Effective measures for secondary prevention of secondary hyperparathyroidism include: | |||
**Maintain adequate [[nutrition]] | |||
**Proper intake of [[vitamin D]] and/or sufficient sunlight exposure | |||
**Adequate [[physical activity]] | |||
* Effective measures for secondary prevention of tertiary hyperparathyroidism include early detection and treatment of hyperparathyroidism by either calcimimetics or [[parathyroidectomy]]. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category: | {{WH}} | ||
{{WS}} | |||
[[Category:Disease]] | |||
[[Category:Medicine]] | |||
[[Category:Endocrinology]] | |||
[[Category:Parathyroid disorders]] | [[Category:Parathyroid disorders]] | ||
[[Category: | [[Category:Up-To-Date]] | ||
Latest revision as of 22:16, 29 July 2020
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Hyperparathyroidism secondary prevention On the Web |
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American Roentgen Ray Society Images of Hyperparathyroidism secondary prevention |
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Risk calculators and risk factors for Hyperparathyroidism secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo parathyroidectomy. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing parathyroidectomy. Effective measures for secondary prevention of secondary hyperparathyroidism include maintain adequate nutrition, proper intake of vitamin D and/or sufficient sunlight exposure, and adequate physical activity. Effective measures for secondary prevention of tertiary hyperparathyroidism include early detection and treatment of hyperparathyroidism by either calcimimetics or parathyroidectomy.
Secondary Prevention
- Secondary prevention of primary hyperparathyroidism includes monitoring for potential progression of disease in patients who do not undergo parathyroidectomy. There are guidelines for monitoring of patients with asymptomatic hyperparathyroidism not undergoing parathyroidectomy. These guidelines include:[1]
- Serum calcium
- Serum calcium should be monitored annually.
- Skeletal monitoring
- Dual-energy X-ray absorptiometry (DEXA) is used for skeletal monitoring. DEXA should be done every 1-2 years (at 3 sites).
- X-ray or vertebral fracture assessment of spine may be done if indications are present such as height loss, and/or back pain.
- Renal monitoring
- Estimated glomerular filtration rate (eGFR) and serum creatinine should be done annually.
- 24-hour biochemical stone profile, renal imaging by x-ray, ultrasound, or CT scan may be considered if renal stones are suspected.
- Serum calcium
- Effective measures for secondary prevention of secondary hyperparathyroidism include:
- Maintain adequate nutrition
- Proper intake of vitamin D and/or sufficient sunlight exposure
- Adequate physical activity
- Effective measures for secondary prevention of tertiary hyperparathyroidism include early detection and treatment of hyperparathyroidism by either calcimimetics or parathyroidectomy.
References
- ↑ Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C; et al. (2014). "Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop". J Clin Endocrinol Metab. 99 (10): 3561–9. doi:10.1210/jc.2014-1413. PMC 5393490. PMID 25162665.