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Management of Asymptomatic Hyperparathyroidism

The Department of Medicine, Harvard Medical School, and the Massachusetts General Hospital Boston, Massachusetts 02114

THE ACCURATE diagnosis and proper management of asymptomatic hyperparathyroidism is a topic that has become of increasing interest for several reasons: the disease is more common than was previously appreciated, many of the patients with the disease are recognized in medical practice because of the widespread use of multiphasic screening tests that lead to detection of hypercalcemia, and the lack of symptoms raises obvious questions about the necessity of surgical correction of hyperparathyroidism. At the same time, it is not clear that the course of asymptomatic hyperparathyroidism is necessarily benign; as with many other disorders, such as hypercholesterolemia or hypertension, there is an appreciation that the condition may be a risk factor for disease processes that have significant morbidity and mortality.

A survey of published reports dealing with the topic leads to the conclusion that in the opinion of many, but by no means all, it is reasonable to recommend medical surveillance in older patients rather than

Received December 10, 1989.

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