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18th Edition (August 5, 2011)
|Guidelines for the Treatment of Asymptomatic Primary Hyperparathyroidism.|
|Written by G. Firman MD|
|Thursday, 22 December 2011 05:50|
The finding of hypercalcemia on routine biochemical testing or in the evaluation of postmenopausal women with osteoporosis is typically the initial clue to the diagnosis of primary hyperparathyroidism. The total serum calcium level, which combines both the free and albumin-bound components of circulating calcium, should be adjusted for the level of albumin. Measurement of ionized calcium may be useful in selected cases, such as in patients with hyperalbuminemia, thrombocytosis, Waldenström's macroglobulinemia, and myeloma; these patients may have elevated levels of total serum calcium, but normal levels of ionized serum calcium (artifactual hypercalcemia).
Guidelines for the Treatment of Asymptomatic Primary Hyperparathyroidism
* Surgery should also be recommended for patients in whom surveillance is not feasible.
† The estimated glomerular filtration rate (milliliters per minute per 1.73 m2 of body-surface area) should be calculated from the serum creatinine concentration, demographic characteristics (age, sex, and race or ethnic group), and other serum measurements (e.g., blood urea nitrogen and albumin concentrations) according to the following equation: 170×(serum creatinine in mg per deciliter) -0.999 ×(blood urea nitrogen in mg per deciliter) -0.170 ×(serum albumin in g per deciliter) 0.318 ×(age in years) -0.176 ×(0.762 if patient is female)×(1.180 if patient is black).
‡ Sites were the lumbar spine, total hip, femoral neck, and distal third of the radius. According to the International Society for Clinical Densitometry, z scores instead of T scores should be used in evaluating bone mineral density in premenopausal women and men younger than 50 years of age.
Created Jan 06, 2012.
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|Last Updated on Tuesday, 24 January 2012 05:01|
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