Diagnosis and management of primary hyperparathyroidism

#### Summary points Primary hyperparathyroidism is the most common cause of hypercalcaemia in the ambulatory setting.1 2 Although this condition can occur at any age, it commonly affects people over the age of 50 years and postmenopausal women.2 3 Over the past few decades it has changed from being a condition usually defined by its symptoms to one that is often discovered on routine screening tests while the patient is still largely asymptomatic. In light of advances in research, new guidelines on the diagnosis and management of asymptomatic primary hyperparathyroidism have recently been developed. We review the presentation, diagnosis, and management of primary hyperparathyroidism for the generalist doctor, with evidence drawn from randomised controlled trials, cohort studies, and the most recent consensus guidelines. #### Sources and selection criteria We searched Medline from 2002 to 2011 using the terms “primary hyperparathyroidism”, “diagnosis”, and “management of primary hyperparathyroidism”. We reviewed all relevant articles as well as the proceedings from …