最近审阅: 七月 2020
最近更新: 三月  2020

小结

定义

病史和体格检查

关键诊断因素

  • 骨质疏松症或骨量减少病史
  • 甲状旁腺功能亢进症家族史或可提示高钙血症的特征表现
  • 肾结石

其他诊断因素

  • 骨痛
  • 睡眠质量差
  • 疲劳
  • 焦虑
  • 抑郁症
  • 记忆减退
  • 肌痛
  • 感觉异常
  • 肌肉痉挛
  • 便秘
  • 明显的神经肌肉功能障碍
  • 腹痛
  • 心血管和代谢功能障碍
  • 坚硬而紧实的颈部肿块

危险因素

  • 女性
  • 年龄 ≥ 50-60 岁
  • PHPT 家族史
  • 多发性内分泌腺瘤 (MEN) 1 型、2A 型或 4 型
  • 目前或既往的锂治疗
  • 甲状旁腺功能亢进症-颌骨肿瘤综合征
  • 头颈部放射史

诊断性检查

首要检查

  • 血清钙
  • 使用免疫放射方法或免疫化学方法检测血清全段 PTH。
更多 首要检查

需考虑的检查

  • 25-羟基维生素 D 水平
  • 血清碱性磷酸酶
  • 血清磷
  • 24 小时尿钙
  • 双能 X 线骨密度测量仪 (DXA) 扫描
  • 骨小梁评分
  • Tc-99 甲氧基异丁基异腈扫描和超声检查
  • 单光子发射 CT+ 甲氧基异丁基异腈扫描
  • 颈部 CT 扫描
  • 颈部 4 维 (4D) CT
  • 颈部 MRI 扫描
更多 需考虑的检查

新兴检查

  • 放射性标记胆碱 PET
更多 新兴检查

治疗流程

撰稿人

Consultant Endocrinologist

Service Lead for Endocrinology

University Hospitals Birmingham

Birmingham

UK

利益声明

JA declares that he has no competing interests.

Consultant Endocrinologist and Honorary Professor of Endocrinology

Associate Medical Director

University Hospitals Birmingham

Birmingham

UK

利益声明

NG is clinical lead for the NICE (UK) clinical guideline on primary hyperparathyroidism.

Dr John Ayuk and Professor Neil Gittoes would like to gratefully acknowledge Dr Fausto Palazzo, Dr Swaroop Gantela, and Dr Nancy D. Perrier, the previous contributors to this topic. FP, SG, and NDP declare that they have no competing interests.

同行评议者展开全部内容

Clinical Assistant

Professor of Medicine

University of Illinois at Chicago

Chicago

IL

利益声明

BS declares that she has no competing interests.

Professor of Medicine

Department of Internal Medicine

University of Iowa

Iowa City

IA

利益声明

UK declares that she has no competing interests.

Professor of Medicine

Medical University of South Carolina

Charleston

SC

利益声明

LE declares that he has no competing interests.

Department of Endocrinology

Elliott Building

Royal Victoria Infirmary

Newcastle-upon-Tyne

UK

利益声明

PP declares that he has no competing interests.

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