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Previous Volume 350:1746-1751 April 22, 2004 Number 17 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 60-year-old woman is noted incidentally to have a calcium level of 10.8 mg per deciliter (2.70 mmol per liter; normal range, 8.4 to 10.2 mg per deciliter [2.10 to 2.55 mmol per liter]). The parathyroid hormone level, as measured on immunoradiometric assay, is 84 pg per milliliter (normal range, 10 to 65). She has never had a kidney stone or a . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Diagnosis

Natural History of Asymptomatic Primary Hyperparathyroidism without Surgery

Outcomes after Parathyroid Surgery

Areas of Uncertainty

Long-Term Risks

Medical Therapy

Calcium and Vitamin D Intake

Other Uncertainties

Guidelines

Conclusions and Recommendations

Source Information

From the Departments of Medicine (J.P.B., S.J.S.) and Pharmacology (J.P.B.), College of Physicians and Surgeons, Columbia University, New York.

Address reprint requests to Dr. Bilezikian at the Department of Medicine, College of Physicians and Surgeons, 630 W. 168th St., New York, NY 10032.

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