Sudden Odynophagia and Globus—A Unique Presentation of a Nonsecreting Parathyroid Adenoma: A Case Report and Literature Review
Table 1
Comparison of guidelines for surgery of asymptomatic HPT patients.
1990
2002
2008
2013
Serum calcium greater than upper limit of normal
1–1.6 mg/dL
1 mg/dL
1 mg/dL
1 mg/dL
Skeletal
BMD by DXA: Z-score less than −2.0 (site unspecified)
BMD by DXA: T-score less than −2.5 at any site
BMD by DXA: T-score less than −2.5 at any site; previous fragility fracture
BMD by DXA: T-score less than −2.5 at lumbar spine, total hip, femoral neck, or distal 2/3 radius vertebral fracture by X-ray, CT, MRI, or VFA
Renal
eGFR reduced by greater than 30% from expected 24 h urine calcium greater than 400 mg/d
eGFR reduced by greater than 30% from expected 24 h urine calcium greater than 400 mg/d
eGFR less than 60 cc/min 24 h urine for calcium not recommended
Creatinine clearance less than 60 cc/min 24 h urine >400 mg/day and increased stone risk by biochemical stone risk analysis; presence of nephrolithiasis or nephrocalcinosis by X-ray, ultrasound, or CT
