Diagnóstico de localización del hiperparatiroidismo primario

  1. Elena Torres Vela
  2. Miguel Quesada Charneco
Revista:
Endocrinología y nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición

ISSN: 1575-0922

Año de publicación: 2006

Volumen: 53

Número: 7

Páginas: 453-457

Tipo: Artículo

DOI: 10.1016/S1575-0922(06)71131-7 SCOPUS: 2-s2.0-33750081101 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Endocrinología y nutrición: órgano de la Sociedad Española de Endocrinología y Nutrición

Resumen

Primary hyperparathyroidism (PHPT) is a common endocrine disease. The presence of PHPT should be suspected in patients with persistent, often mild, hypercalcemia in the absence of any other apparent etiology. Hyperparathyroidism is the most frequent cause of hypercalcemia in the outpatient setting and is usually discovered incidentally by routine laboratory testing. Currently, most patients are asymptomatic. The only permanently effective therapy for patients with PHPT is surgery, with a high cure rate (95%) and few perioperative complications (5%). Parathyroid imaging is not required in the diagnosis of PHPT. The role of preoperative localization in patients undergoing initial neck exploration is unclear, since a bilateral approach in the hands of experienced surgeons achieves a high cure rate. Preoperative localization of adenomas with ultrasonography or sestamibi scanning allows a minimally invasive approach to be used. Localization studies are required when PHPT persists or recurs after surgery.

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Información de financiación

En 1990, una conferencia de consenso organizada por los NIH (National Institutes of Health) pretendió racionalizar las bases para el tratamiento quirúrgico de los pacientes asintomáticos8. Posteriormente, en 20029, un nuevo consenso recomendó la paratiroidectomía en los siguientes casos: a) edad < 50 años; b) Ca > 1 mg del rango superior de la normalidad; c) hipercalciuria > 400 mg/día; d) un 30% de descenso de función renal; e) imposibilidad de seguimiento, y f) complica-ciones del HPT: litiasis, osteoporosis (T-score < –2,5) (tabla 1).

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Fuente de los datos: Dialnet