Patients whose parathyroid activity is elevated above normal are referred to as having
hyperparathyroidism. This study will help researchers better understand the causes of
hyperthyroidism and to evaluate and improve methods for diagnosis and treatment.
In this study, patients diagnosed with or suspected of having hyperparathyroidism will be
selected to participate. In addition, patients with related conditions such as parathyroid
tumors, will also be selected.
Subjects will be asked to provide blood and urine for testing to confirm their condition.
They will then be surgically treated by removal of the parathyroid gland(s)
Subjects with parathyroid tumors will undergo several diagnostic tests to determine the exact
location of the tumor as well as the tumor's activity. The tests may include; ultrasounds,
nuclear scanning, CT scans, MRI, and specialized blood testing.
Sometimes parathyroidectomy leads to hypoparathyroidism. Options for treating the patients
after the surgical procedure will also be addressed. Calcium and Vitamin D supplements are
typically the mainstay of post parathyroidectomy therapy. Other potential treatments include
transplanting the parathyroid gland(s) to other areas of the body.
Patients with confirmed or suspected primary hyperparathyroidism or complications therefrom
(such as postoperative hypoparathyroidism) will be admitted for diagnosis and treatment. The
principal diagnostic components are calcium in serum and urine and parathyroid hormone in
serum. Patients with moderately to highly severe primary hyperparathyroidism will be treated.
Treatment will be mainly by parathyroidectomy. Other options are medications or no
intervention. Patients with a hyperparathyroid syndrome may be managed for their
extraparathyroid features. Preoperative testing to localize parathyroid neoplasm(s) will be
used usually and with more extended methods in cases with prior neck surgery. Preoperative
tumor localization tests will be selected according to clinical indications from the
following: ultrasound, technetium-thallium scan, computerized tomography, magnetic resonance
imaging, fine needle aspiration for parathyroid hormone assay, selective arteriogram,
selective venous catheterization for parathyroid hormone assay. Options for management of
postoperative hypocalcemia include calcium, vitamin D analogs, parathyroid autografts and
synthetic parathyroid hormone. Research specimens may consist of blood or tumors.
- INCLUSION CRITERIA:
Patients (male or female any age) with known or suspected primary hyperparathyroidism or a
related disorder (such as familial multiple endocrine neoplasia type 1 [MEN1]) will be
The vast majority of patients will be greater than age 18.
In the rare occasion where special resources might be appropriate (uremic patient, young
child), the availability of special resources would be confirmed prior to admission.
There are no absolute exclusions.