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Primary hyperparathyroidism

机译：原发性甲状旁腺功能亢进

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In this Review, we describe the pathogenesis, diagnosis and management of primary hyperparathyroidism (PHPT), with a focus on recent advances in the field. PHPT is a common endocrine disorder that is characterized by hypercalcaemia and elevated or inappropriately normal serum levels of parathyroid hormone. Most often, the presentation of PHPT is asymptomatic in regions of the world where serum levels of calcium are routinely measured. In addition to mild hypercalcaemia, PHPT can manifest with osteoporosis and hypercalciuria as well as with vertebral fractures and nephrolithiasis, both of which can be asymptomatic. Other clinical forms of PHPT, such as classical disease and normocalcaemic PHPT, are less common. Parathyroidectomy, the only curative treatment for PHPT, is recommended in patients with symptoms and those with asymptomatic disease who are at risk of progression or have subclinical evidence of end-organ sequelae. Parathyroidectomy results in an increase in BMD and a reduction in nephrolithiasis. Various medical therapies can increase BMD or reduce serum levels of calcium, but no single drug can do both. More data are needed regarding the neuropsychological manifestations of PHPT and the pathogenetic mechanisms leading to sporadic PHPT, as well as on risk factors for complications of the disorder. Future work that advances our knowledge in these areas will improve the management of the disorder.
机译：在本综述中，我们描述了原发性甲状旁腺功能亢进（PHPT）的发病机制，诊断和管理，重点是该领域的最近进步。 PHPT是一种常见的内分泌紊乱，其特征在于高钙血症和升高或不恰当的正常血清甲状旁腺激素。通常，PHPT的呈现是常规测量血清钙水平的世界区域中的无症状。除了温和的高钙血症外，PHPT还可以用骨质疏松症和高钙尿以及椎体骨折和肾血红蛋现，两者都可以是无症状的。其他临床形式的PHPT（如经典疾病和常规疾病），都不常见。甲状旁腺切除术，PHPT的唯一疗法治疗，推荐在患有症状的患者和具有进展风险的无症状疾病的患者中，患有患者的患者或具有末端器官后遗症的亚临床证据。甲状旁腺切除术导致BMD增加和肾血红病的减少。各种医疗疗法可以增加BMD或减少血清钙水平，但没有单一的药物可以做两者。关于PHPT神经心理学表现的更多数据以及导致散发阵容的致病机制以及疾病并发症的危险因素。未来的工作，推进我们在这些地区的知识将改善对疾病的管理。

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