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Primary Hyperparathyroidism in Adults: Recent Developments in Diagnosis and Management
Elizabeth Wootton1,2, Sunita M C De Sousa3,4, Richard L Prince5
1Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
The Medical Journal of Australia
|May 14, 2026
Summary
Primary hyperparathyroidism affects about 1% of people. Diagnosis involves biochemical tests, screening for complications, and sometimes genetic testing, with surgery offering a cure.
Area of Science:
- Endocrinology
- Biochemistry
- Genetics
Background:
- Primary hyperparathyroidism (PHP) affects approximately 1% of the general population.
- Diagnosis involves serum calcium, parathyroid hormone, and urine calcium testing.
- Complications include osteoporosis, renal disease, and neuropsychiatric disturbances.
Purpose of the Study:
- To outline diagnostic criteria for primary hyperparathyroidism.
- To discuss screening for complications and hereditary forms.
- To review current surgical and diagnostic management strategies.
Main Methods:
- Biochemical testing of serum and urine.
- Screening for PHP-related complications.
- Genetic testing in selected individuals.
- Preoperative imaging for parathyroid gland localization.
Main Results:
- Up to 10% of PHP cases have a hereditary basis.
- Minimally invasive surgery is the preferred curative approach.
- Normocalcemic PHP presents diagnostic challenges.
Conclusions:
- PHP diagnosis requires comprehensive biochemical and complication screening.
- Genetic testing is crucial for hereditary cases.
- Further research is needed for non-classical PHP and normocalcemic variants.
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