Читать книгу Parathyroid Disorders - Группа авторов - Страница 52

Data relating to NPHPT natural history are scanty. It is thought that years prior to a clinical diagnosis of PHPT, calcium homeostasis shows signs of perturbations. Latent PHPT may be characterized by either NPHPT or normoparathyroid hypercalcemia. Such patients should be offered long-term follow-up to ascertain whether their biochemical profile represents an early state of PHPT. Rejnmark et al. [47] found that the time from inclusion until a diagnosis of PHPT was a median of 5.6 years. Parathyroidectomy was performed in 97%. At the cohort inclusion, undiagnosed PHPT was present in 63% of the cases. Among those without HPHPT at inclusion (n = 43), 55% had NPHPT and 31% had normoparathyroid hypercalcemia. Overall, 25(OH)D levels were lower in the cases. Compared with their matched controls, 25(OH)D levels were lower in NPHPT but not in normoparathyroid hypercalcemia. An adenoma was removed from 78% of the cases with NPHPT, whereas 39% of the cases with normoparathyroid hypercalcemia had parathyroid hyperplasia [47].