Primary hyperparathyroidism and familial hyperparathyroid syndromes

BACKGROUND Ninety percent of cases of hypercalcaemia are due to primary hyperparathyroidism or hypercalcaemia of malignancy. OBJECTIVE This article outlines the diagnostic features of primary hyperparathyroidism and determines who would benefit from parathyroidectomy. It also aims to raise awareness of familial hyperparathyroid syndromes. DISCUSSION Diagnosis of primary hyperparathyroidism requires hypercalcaemia, elevated or inappropriately normal serum parathyroid hormone and a fractional urinary excretion of calcium greater than 0.02. Many patients benefit from parathyroidectomy, which has a high rate of cure.