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  • Sallie Powell

Changing ideas about Primary Hyperparathyroidism 2021

So much has changed in the last twelve months. I am hoping a positive change this year will be increased awareness of formerly denied concepts about normohormonal and normocalcemic PHPT. They are both real, they are both just as devastating to health as hypercalcaemic PHPT. Up until very recently hardly any doctors took vitamin D levels seriously. Many hospital labs refused to even test vitamin D. It took a pandemic to change those views as well as reading some research. I hope doctors and surgeons will read our recent case stories to open their minds to classifications of PHPT that we have been discussing for a few years. Pictorial evidence that can no longer be denied.

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Shad Khan - Consultant Endocrine and General Surgeon at Oxford University Hospitals:

'Normocalcaemic hyperparathyroidism (NCPHPT) is increasingly becoming accepted as a condition requiring surgical correction - much like primary hyperparathyroidism (PHPT). In this variant patients have an elevated parathyroid hormone level whilst displaying normal calcium levels in the blood. Nevertheless there is a growing body of evidence which suggests that kidney stones, osteoporosis and a multitude of symptoms found in the more conventional PHPT occur to the same extent in NCPHPT. Anecdotal evidence would suggest that a lot of benefit can be gained through surgical cure and there is growing concern about waiting until there is organ damage before offering surgery. Not many units are recognising this as yet but at Oxford we are increasingly seeing and offering surgery for NCPHPT with quality of life dramatically improving following successful surgery'