Italian Guidelines for the Management of Sporadic Primary Hyperparathyroidism

被引：2

作者：

Vescini, Fabio ^{[1
]}

Borretta, Giorgio ^{[2
]}

Chiodini, Iacopo ^{[3
]}

Boniardi, Marco ^{[4
]}

Carotti, Marina ^{[5
]}

Castellano, Elena ^{[2
]}

Cipriani, Cristiana ^{[6
]}

Eller-Vainicher, Cristina ^{[7
]}

Giannini, Sandro ^{[8
]}

Iacobone, Maurizio ^{[9
]}

Salcuni, Antonio Stefano ^{[1
]}

Saponaro, Federica ^{[10
]}

Spiezia, Stefano ^{[11
]}

Versari, Annibale ^{[12
]}

Zavatta, Guido ^{[13
]}

Mitrova, Zuzana ^{[14
]}

Saulle, Rosella ^{[14
]}

Vecchi, Simona ^{[14
]}

Antonini, Debora ^{[15
]}

Basile, Michele ^{[15
]}

Giovanazzi, Alexia ^{[16
]}

Paoletta, Agostino ^{[17
]}

Papini, Enrico ^{[18
]}

Persichetti, Agnese ^{[19
]}

Samperi, Irene ^{[20
]}

Scoppola, Alessandro ^{[21
]}

Novizio, Roberto ^{[22
]}

Calo, Pietro Giorgio ^{[23
]}

Cetani, Filomena ^{[24
]}

Cianferotti, Luisella ^{[25
]}

Corbetta, Sabrina ^{[26
]}

De Rimini, Maria Luisa ^{[27
]}

Falchetti, Alberto ^{[28
]}

Iannetti, Giovanni ^{[29
]}

Laureti, Stefano ^{[30
]}

Lombardi, Celestino Pio ^{[31
]}

Madeo, Bruno ^{[32
]}

Marcocci, Claudio ^{[24
]}

Mazzaferro, Sandro ^{[33
]}

Miele, Vittorio ^{[34
]}

Minisola, Salvatore ^{[35
]}

Palermo, Andrea ^{[36
]}

Pepe, Jessica ^{[6
]}

Scillitani, Alfredo ^{[37
]}

Tonzar, Laura ^{[1
]}

Grimaldi, Franco ^{[38
]}

Cozzi, Renato ^{[39
]}

Attanasio, Roberto ^{[40
]}

机构：

[1] Azienda Sanit Univ Friuli Cent, Endocrinol Unit, PO Santa Maria Misericordia, Udine, Italy

[2] Osped Santa Croce & Carle Hosp, Dept Endocrinol Diabet & Metab, Cuneo, Italy

[3] Univ Milan, ASST Grande Osped Metropolitano Niguarda, Endocrinol Dept, Dept Biotechnol & Translat Med, Milan, Italy

[4] ASST Grande Osped Metropolitano Niguarda, Gen Oncol & Miniinvas Surg Dept, Milan, Italy

[5] Univ Politecn Marche, Dept Radiol, AOU Marche, Ancona, Italy

[6] Sapienza Univ Rome, Dept Clin Internal Anesthesiol & Cardiovasc Sci, Rome, Italy

[7] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Endocrinol Unit, Milan, Italy

[8] Univ Padua, Clin Med 1, Dept Med, Padua, Italy

[9] Univ Padua, Dept Surg Oncol & Gastroenterol, Endocrine Surg Unit, Padua, Italy

[10] Univ Pisa, Dept Surg Med & Mol Pathol & Crit Care Med, Pisa, Italy

[11] Osped Mare, Dept Endocrine & Ultrasound Guided Surg, Naples, Italy

[12] Azienda Unita Sanit Locale IRCCS Reggio Emilia, Nucl Med Unit, Reggio Emilia, Italy

[13] Alma Mater Studiorum Univ Bologna, IRCCS Azienda Osped Univ Bologna, Dept Med & Surg Sci DIMEC, Div Endocrinol & Diabet Prevent & Care, Bologna, Italy

[14] Lazio Reg Hlth Serv, Dept Epidemiol, Rome, Italy

[15] Univ Cattolica Sacro Cuore, High Sch Econ & Management Hlth Syst, Rome, Italy

[16] Azienda Provi Serv Sanitari Prov Autonoma Trento, Trento, Italy

[17] ULSS6 Euganea, Dept Endocrinol, Padua, Italy

[18] Osped Regina Apostolorum, Endocrinol, Albano Laziale, Italy

[19] Minist Interior, Dept Firefighters Publ Rescue & Civil Def, Rome, Italy

[20] ASL Novara, Endocrinol, Novara, Italy

[21] Osped St Spirito, Endocrinol, Rome, Italy

[22] Sacred Heart Catholic Univ, IRCCS & Fdn, Agostino Gemelli Univ Polyclin, Inst Microbiol, Rome, Italy

[23] Univ Cagliari, Dept Surg Sci, Cagliari, Italy

[24] Univ Pisa, Dept Clin & Expt Med, Endocrine Unit 2, Pisa, Italy

[25] Univ Florence, AOU Careggi, Dept Biomed Expt & Clin Sci, Bone Metab Dis Unit, Florence, Italy

[26] Univ Milan, Dept Biomed Surg & Dent Sci, Milan, Italy

[27] Monaldi Hosp, Cardiovasc & Metab Med Unit, Naples, Italy

[28] IRCCS Ist Auxol Italiano, Expt Lab Bone Metab Res, Milan, Italy

[29] S Spirito Hosp, Dept Hematol & Oncol, Pescara, Italy

[30] Usl Umbria 1, Ple Gambuli, I-06132 Perugia, Italy

[31] Osped Gemelli, Rome, Italy

[32] Osped Civile Baggiovara, Dept Med Specialties, Unit Endocrinol, Azienda Osped Univ Modena, Modena, Italy

[33] Sapienza Univ Rome, Dept Translat & Precis Med, Nephrol Unit, Rome, Italy

[34] Careggi Univ Hosp, Dept Emergency Radiol, I-50134 Florence, Italy

[35] Sapienza Univ Rome, Dipartimento Med Interna Specialita Med, UOC Reumatol, Azienda Policlinico Umberto Policlinico,155, I-00161 Rome, Italy

[36] Fdn Policlin Univ Campus Biomed, Unit Metab Bone & Thyroid Dis, Rome, Italy

[37] Fdn IRCCS Casa Sollievo Sofferenza, Unit Endocrinol, San Giovanni Rotondo, FG, Italy

[38] ASUFC, Udine, Italy

[39] INFN, Milan, Italy

[40] AME Sci Comm, Milan, Italy

来源：

ENDOCRINE METABOLIC & IMMUNE DISORDERS-DRUG TARGETS | 2024年 / 24卷 / 08期

关键词：

Hyperparathyroidism; sporadic; cinacalcet; bisphosphonate; surgery; parathyroidectomy; surveillance; pharmacoeconomy; MILD PRIMARY HYPERPARATHYROIDISM; ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM; BONE-MINERAL DENSITY; PARATHYROID ADENOMA LOCALIZATION; GUIDED THERMAL ABLATION; COMPUTED-TOMOGRAPHY; VERTEBRAL FRACTURES; CARDIOVASCULAR RISK; ORAL ALENDRONATE; RANDOMIZED-TRIAL;

D O I：

10.2174/0118715303260423231122111705

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aim This guideline (GL) is aimed at providing a clinical practice reference for the management of sporadic primary hyperparathyroidism (PHPT) in adults. PHPT management in pregnancy was not considered. Methods This GL has been developed following the methods described in the Manual of the Italian National Guideline System. For each question, the panel appointed by Associazione Medici Endocrinology (AME) and Societ & agrave; Italiana dell'Osteoporosi, del Metabolismo Minerale e delle Malattie dello Scheletro (SIOMMMS) identified potentially relevant outcomes, which were then rated for their impact on therapeutic choices. Only outcomes classified as "critical" and "important" were considered in the systematic review of evidence. Those classified as "critical" were considered for the clinical practice recommendations. Results The present GL provides recommendations about the roles of pharmacological and surgical treatment for the clinical management of sporadic PHPT. Parathyroidectomy is recommended in comparison to surveillance or pharmacologic treatment in any adult (outside of pregnancy) or elderly subject diagnosed with sporadic PHPT who is symptomatic or meets any of the following criteria: center dot Serum calcium levels >1 mg/dL above the upper limit of normal range. center dot Urinary calcium levels >4 mg/kg/day. center dot Osteoporosis disclosed by DXA examination and/or any fragility fracture. center dot Renal function impairment (eGFR <60 mL/min). center dot Clinic or silent nephrolithiasis. center dot Age <= 50 years. Monitoring and treatment of any comorbidity or complication of PHPT at bone, kidney, or cardiovascular level are suggested for patients who do not meet the criteria for surgery or are not operated on for any reason. Sixteen indications for good clinical practice are provided in addition to the recommendations. Conclusion The present GL is directed to endocrinologists and surgeons - working in hospitals, territorial services or private practice - and to general practitioners and patients. The recommendations should also consider the patient's preferences and the available resources and expertise.

引用

页码：991 / 1006

页数：16

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