European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE Educational Program of Parathyroid Disorders (PARAT 2021). Issue 2 (13th January 2022)

• Record Type: Journal Article
• Authors: Bollerslev, Jens; Rejnmark, Lars; Zahn, Alexandra; Heck, Ansgar; Appelman-Dijkstra, Natasha M; Cardoso, Luis; Hannan, Fadil M; Cetani, Filomena; Sikjaer, Tanja; Formenti, Anna Maria; Björnsdottir, Sigridur; Schalin-Jäntti, Camilla; Belaya, Zhanna; Gibb, Fraser; Lapauw, Bruno; Amrein, Karin; Wicke, Corinna; Grasemann, Corinna; Krebs, Michael; Ryhänen, Eeva; Makay, Özer; Minisola, Salvatore; Gaujoux, Sébastien; Bertocchio, Jean-Philippe; Hassan-Smith, Zaki; Linglart, Agnès; Winter, Elizabeth M; Kollmann, Martina; Zmierczak, Hans-Georg; Tsourdi, Elena; Pilz, Stefan; Siggelkow, Heide; Gittoes, Neil; Marcocci, Claudio; Kamenický, Peter;
• Other Names: Carola Zillikens author non-byline.; Morten Frost author non-byline.; Lars Rolighed author non-byline.; Antonio Sitges-Serra author non-byline.; Sabrina Corbetta author non-byline.; Brigitte Decallonne author non-byline.; Iuliana Gherlan author non-byline.; Laura Gianotti author non-byline.; Daniel Grigorie author non-byline.; Elif Hindié author non-byline.; Mairead Kiely author non-byline.; Kirsten Lindner author non-byline.; Polyzois Makras author non-byline.; Barbara Obermayer-Pietsch author non-byline.; Fastino R Perez-Lopez author non-byline.; Mikkel Pretorius author non-byline.; Federica Saponaro author non-byline.; Christian Trummer author non-byline.; Kyriakos Vamvakidis author non-byline.; Natia Vashakmadze author non-byline.; Maria P Yavropoulou author non-byline.
• Is Part Of: European journal of endocrinology. Volume 186:Issue 2(2022)
• Page Start: R33
• Page End: R63
• Publication Date: 2022-01-13
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EJE-21-1044
• Languages: English
• ISSNs: 0804-4643

Abstract

Abstract : This European expert consensus statement provides recommendations for the diagnosis and management of primary hyperparathyroidism (PHPT), chronic hypoparathyroidism in adults (HypoPT), and parathyroid disorders in relation to pregnancy and lactation. Specified areas of interest and unmet needs identified by experts at the second ESE Educational Program of Parathyroid Disorders in 2019 were discussed during two virtual workshops in 2021 and subsequently developed by working groups with interest in the specified areas. PHPT is a common endocrine disease. However, its differential diagnosis of familial hypocalciuric hypercalcemia (FHH), the definition and clinical course of normocalcemic PHPT, and the optimal management of its recurrence after surgery represents areas of uncertainty requiring clarifications. HypoPT is an orphan disease characterized by low calcium concentrations due to insufficient PTH secretion, most often secondary to neck surgery. Prevention and prediction of surgical injury to the parathyroid glands are essential to limit the disease-related burden. Long-term treatment modalities including the place for PTH replacement therapy and the optimal biochemical monitoring and imaging surveillance for complications to treatment in chronic HypoPT need to be refined. The physiological changes in calcium metabolism occurring during pregnancy and lactation modify the clinical presentation and management of parathyroid disorders in these periods of life. Modern interdisciplinary approaches to PHPT and HypoPT in pregnant and lactating women and their newborn children are proposed. The recommendations on clinical management presented here will serve as background for further educational material aimed at a broader clinical audience and were developed with the focus on endocrinologists in training.