Yes please tell me what to do with the normocalcemic hyperpara's! #aace2021 #Endotwitter
In those with primary hyperparathyroidism the majority are asymptomatic. Next highest is kidney stones. It affects the radius more than fem neck more than lumbar spine #AACE2021 #Endotwitter #bone
Differential for those with hypercalcemia with normal/high PTH #AACE2021 #Endotwitter #bone
Approach to a pt with primary hyperpara who you suspect a genetic etiology #AACE2021 #Endotwitter
Higher fx risk in both symptomatic and nonsymptomatic hyperparathyroidism that improves after successful parathyroidectomy #AACE2021 #Endotwitter
Blue is endo/bone guideline, pink is surgery guidelines for hyperpara. Surgeons recommend considering surgery for neuropsych/cognitive sx -- strong recommendation with low-quality evidence. #Endotwitter #AACE2021
Don't restrict calcium and vit d in PHPT. Replete Vit D >20 and calcium intake should be normal #AACE2021 #Endotwitter
Normocalcemic PHPT -- rule out 2ndary cause (vit d def, malabsorption, CKD, meds) #Endotwitter #AACE2021
Natural history of normocalcemic PHPT ---FU only 1-4yrs with 0-20% developing hypercalcemia #Endotwitter #AACE2021
So what do you do with normocalcemic hypoparathyroidism? Monitor and if clinically or biocehemical progression/worsening then surgery #AACE2021 #Endotwitter
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