Abstract
Because of widespread screening of the serum calcium concentration, most patients with primary hyperparathyroidism now present with very mild disease instead of the severe bone or kidney manifestations seen in the past. The US National Institutes of Health (NIH) in their 2002 guidelines recommend surgery for patients with symptoms and for select patients without symptoms. But many now argue that all patients with primary hyperparathyroidism should be referred for surgery to reduce fracture risk and enhance general health.
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