Italian Guidelines for the Management of Sporadic Primary Hyperparathyroidism-Reference-Cited by-同舟云学术

Italian Guidelines for the Management of Sporadic Primary Hyperparathyroidism

Published:2023-12-14 Issue: Volume:24 Page:
ISSN:1871-5303
Container-title:Endocrine, Metabolic & Immune Disorders - Drug Targets
language:en
Short-container-title:EMIDDT

Author:

Vescini Fabio¹,Borretta Giorgio²,Chiodini Iacopo³,Boniardi Marco⁴,Carotti Marina⁵,Castellano Elena²,Cipriani Cristiana⁶,Eller-Vainicher Cristina⁷,Giannini Sandro⁸,Iacobone Maurizio⁹,Salcuni Antonio Stefano¹,Saponaro Federica¹⁰,Spiezia Stefano¹¹,Versari Annibale¹²,Zavatta Guido¹³,Mitrova Zuzana¹⁴,Saulle Rosella¹⁴,Vecchi Simona¹⁴,Antonini Debora¹⁵,Basile Michele¹⁵,Giovanazzi Alexia¹⁶,Paoletta Agostino¹⁷,Papini Enrico¹⁸,Persichetti Agnese¹⁹,Samperi Irene²⁰,Scoppola Alessandro²¹,Novizio Roberto²²,Calò Giorgio²³,Cetani Filomena²⁴,Cianferotti Luisella²⁵,Corbetta Sabrina²⁶,De Rimini Maria Luisa²⁷,Falchetti Alberto²⁸,Iannetti Giovanni²⁹,Laureti Stefano³⁰,Lombardi Celestino Pio³¹,Madeo Bruno³²,Marcocci Claudio²⁴,Mazzaferro Sandro³³,Miele Vittorio³⁴,Minisola Salvatore³⁵,Palermo Andrea³⁶,Pepe Jessica⁶,Scillitani Alfredo³⁷,Tonzar Laura¹,Grimaldi Franco³⁸,Cozzi Renato³⁹,Attanasio Roberto⁴⁰^ORCID

Affiliation:

1. Endocrinology Unit, Azienda Sanitaria-Universitaria Friuli Centrale, P.O. Santa Maria della Misericordia, Udine

2. Department of Endocrinology, Diabetes and Metabolism, Ospedale Santa Croce and Carle Hospital, Cuneo

3. Endocrinology Department, ASST Grande Ospedale Metropolitano di Niguarda, Milan; Department of Biotechnology and Translational Medicine, University of Milan

4. General Oncologic and Mini-invasive Surgery Department, ASST Grande Ospedale Metropolitano di Niguarda, Milan

5. Department of Radiology, AOU delle Marche, Ancona, Università Politecnica delle Marche

6. Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome

7. Endocrinology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan

8. Clinica Medica 1, Department of Medicine, University of Padova

9. Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova

10. Department of Surgical, Medical, and Molecular Pathology and Critical Care Medicine, University Pisa

11. Department of Endocrine and Ultrasound-Guided Surgery, Ospedale del Mare, Naples

12. Nuclear Medicine, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia

13. Division of Endocrinology and Diabetes Prevention and Care, IRCCS AOU di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna

14. Department of Epidemiology, Lazio Region Health Service, Rome

15. High School of Economy and Management of Health Systems, Catholic University of Sacred Heart, Rome

16. Azienda Provinciale per i Servizi Sanitari della Provincia Autonoma di Trento

17. Endocrinology,, ULSS6 Euganea, Padova

18. Endocrinology, Ospedale Regina Apostolorum, Albano Laziale

19. Ministry of Interior - Department of Firefighters, Public Rescue and Civil Defense, Rome

20. Endocrinology, ASL Novara

21. Endocrinology, Ospedale Santo Spirito, Rome

22. Endocrinology and Metabolism, Agostino Gemelli University Polyclinic (IRCCS), Catholic University of the Sacred Heart, Rome

23. SIUEC President, Department of Surgical Sciences, University of Cagliari

24. Endocrine Unit 2, Department of Clinical and Experimental Medicine, University of Pisa

25. Bone Metabolic Diseases Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, AOU Careggi, Florence

26. Bone Metabolism and Diabetes, IRCCS Istituto Auxologico Italiano, Milan; Department of Biomedical, Surgical and Dental Sciences, University of Milan

27. AIMN President, Nuclear Medicine Unit, AORN Ospedali dei Colli, Naples

28. Laboratory of Experimental Clinical Research on Bone Metabolism, Istituto Auxologico Italiano IRCCS, Milan

29. SIUMB President, Ultrasound Unit, S. Spirito Hospital, Pescara

30. General Practitioner, USL Umbria 1, Perugia

31. Endocrine Surgery, Ospedale Gemelli, Rome

32. Unit of Endocrinology, Department of Medical Specialties, Ospedale Civile di Baggiovara, Azienda Ospedaliero-Universitaria di Modena

33. Nephrology Unit at Policlinico Umberto I Hospital and Department of Translation and Precision Medicine, Sapienza University of Rome

34. Department of Emergency Radiology, Careggi University Hospital, Florence

35. UOC Medicina Interna A, Malattie Metaboliche dell'Osso, Ambulatorio Osteoporosi e Osteopatie Fragilizzanti, Sapienza University of Rome

36. Unit of Thyroid and Bone-Metabolic Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, Fondazione Policlinico Universitario Campus Bio-Medico, Rome

37. Unit of Endocrinology, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG)

38. AME past President, Udine

39. AME President, Milan

40. AME Scientific Committee, Milan, Italy

Abstract

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 Società 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: • Serum calcium levels >1 mg/dL above the upper limit of normal range. • Urinary calcium levels >4 mg/kg/day. • Osteoporosis disclosed by DXA examination and/or any fragility fracture. • Renal function impairment (eGFR <60 mL/min). • Clinic or silent nephrolithiasis. • 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.

Publisher

Bentham Science Publishers Ltd.

Subject

Immunology and Allergy,Endocrinology, Diabetes and Metabolism