فرط نشاط جارات الدرق الأولي في تعدد أورام الغدد الصماء من النوع الأول — متى يكون العلاج مُشاراً إليه

References

• Parathyroidectomy is indicated in children, adolescents, and adults diagnosed with MEN1-related primary hyperparathyroidism who are symptomatic or have evidence of target organ involvement.
• Irrespective of symptoms, parathyroidectomy is indicated in adults diagnosed with MEN1-related primary hyperparathyroidism, in whom total serum calcium levels are consistently >1 mg/dL (0·25 mmol/L) above the upper limit of the reference range of the specific assay used.
• In children, adolescents, and adults with MEN1-related primary hyperparathyroidism, subtotal (3–3·5 gland) parathyroidectomy with concomitant transcervical thymectomy is the recommended index operation, which should be performed by an experienced MEN1 parathyroid surgeon.
• In selected cases, unilateral clearance can be considered as the index operation for children or adolescents with MEN1-related primary hyperparathyroidism.
• The goals of management are to maintain a (near) normal serum calcium concentration for as long as possible with as few operations as possible and preventing or limiting target organ damage while avoiding permanent post-operative hypoparathyroidism.