Hopp til innhold
NHI.no
Annonse

Hyperparatyreoidisme: Behandling

Innhold i artikkelen

Det viktigste vil være å prøve å normalisere kalsiumnivået. Dersom du har en mild form uten symptomer, vil "egenbehandling" være førstevalget. Det består i mye fysisk aktivitet, rikelig med drikke og unngå mat/kosttilskudd som inneholder mye kalsium. Hos kvinner som har passert overgangsalderen, vil man vurdere behandling for å forebygge beinskjørhet. Utover dette vil regelmessige kontroller være viktig for å følge tilstanden. Mange av dem som er uten symptomer, vil aldri merke noe, og legen starter som regel ikke behandling før symptomene eventuelt melder seg.

Annonse

For dem med symptomgivende hyperparatyroidisme er kirurgi mest aktuelt. For eldre som ikke vil tåle en operasjon, kan medisin dempe tilstanden, men vil ikke helbrede den.

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Hyperparatyreoidisme . Referanselisten for dette dokumentet vises nedenfor

  1. Bollerslev J, Øgard CG, Schwarz P, Vestergaard H, Vestergaard P. Primær hyperparatyroidisme - forekomst, symptomer, komplikationer og behandling. Ugeskr Læger 2005; 167: 910-4. PubMed
  2. Marcocci C, Cetani F. Clinical practice. Primary hyperparathyroidism. N Engl J Med. 2011 Dec 22; 365(25):2389-97. PMID: 22187986 PubMed
  3. Bilezikian JP, Silverberg SJ. Asymptomatic primary hyperparathyroidism. N Engl J Med 2004; 350: 1746-51. PubMed
  4. Wilhelm SM, Wang TS, Ruan DT. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg 2016; 151(10): 959-68. pmid:27532368 PubMed
  5. Eriksen EF, Bollerslev J, Lima K et al. Primær hyperparatyreoidisme. Nasjonal veileder i Endokrinologi. Sist publisert 26.02.2020.
  6. Campbell MJ. The Definitive Management of Primary Hyperparathyroidism Who Needs an Operation?. JAMA 2017; 317(11): 1167-68. pmid:28324077 PubMed
  7. Pallan S, Rahman MO, Khan AA. Diagnosis and management of primary hyperparathyroidism. Clinical review. BMJ 2012; 344: e1013. pmid: 22431655 PubMed
  8. Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands. Am J Surg 2006; 191: 418-23. PubMed
  9. Marx SJ, Simonds WF, Agarwal SK, Burns AL, Weinstein LS, Cochran C, et al. Hyperparathyroidism in hereditary syndromes: special expressions and special managements. J Bone Miner Res 2002;17 (suppl 2):N37-43. pmid: 12412776 PubMed
  10. Thakker RV. Multiple endocrine neoplasia type 1. Endocrinol Metab Clin North Am 2000;29:541-67. PubMed
  11. Brown EM. Familial hypocalciuric hypercalcemia and other disorders with resistance to extracellular calcium. Endocrinol Metab Clin North Am 2000;29:503-22. PubMed
  12. Bundgaard MJ, Kvist E, Kristensen B. Ukarakteristiske symptomer og primær hyperparatyreoidisme. Ugeskr Læger 2000; 162: 4909-11. PubMed
  13. Bargren AE, Repplinger D, Chen H, Sippel RS. Can biochemical abnormalities predict symptomatology in patients with primary hyperparathyroidism?. J Am Coll Surg 2011; 213: 410-4. PubMed
  14. NICE guideline (NG132). Hyperparathyroidism (primary): diagnosis, assessment and initial management. 2019. www.nice.org.uk
  15. Ayuk J, Gittoes N. Primary hyperparathyroidism. BestPractice, last updated Sep 26, 2016
  16. Haber RS, Kim CK, and Inabnet WB. Ultrasonography for preoperative localisation of enlarged parathyroid glands in primary hyperparathyroidism: comparison with 99mtechnetium sestamibi scintigraphy. Clin Endocrinol 2002;57: 241-9. PubMed
  17. Bollerslev J, Jansson S, Mollerup CL et al. Medical observation, compared with parathyroidectomy, for asymptomatic primary hyperparathyroidism: a prospective, randomized trial. J Clin Endocrinol Metab 2007; 92: 1687-92. PubMed
  18. Udelsman R, Pasieka J, Sturgeon C, et al. Surgery for asymptomatic primary hyperparathyroidism. J Clin Endocrinol Metab 2009; 94: 366-72. PubMed
  19. Yeh MW, Zhou H, Adams AL, et al. The relationship of parathyroidectomy and bisphosphonates with fracture risk in primary hyperparathyroidism. Ann Intern Med 2016. pmid: 27043778 PubMed
  20. Udelsman R, Lin Z, Donovan P. The superiority of minimally invasive parathyroidectomy based on 1650 consecutive patients with primary hyperparathyroidism. Ann Surg 2011; 253: 585-91. PubMed
  21. Mollerup CL, Vestergaard P, Frøkjær VG, Mosekilde L, Christiansen PM, Blichert-Toft M. Nyresten og primær hyperparatyroidisme. Ugeskr Læger 2004; 166: 3726-8. PubMed
  22. Michels TC, Kelly KM. Parathyroid disorders. Am Fam Physician 2013; 88: 249-57. pmid: 23944728 PubMed
  23. Vestergaard P, Mosekilde L. Incidens af primær hyperparatyroidisme, hyppighed af operation og mortalitet belyst ved data fra Landspatientregistret. Ugeskr Læger 2004; 166: 41-5. pmid: 14752992 PubMed
  24. Mollerup CL, Vestergaard P, Frøkjær VG et al. Risk of renal stone events in primary hyperparathyroidism before and after parathyroid surgery: controlled retrospective follow up study. BMJ 2002; 325: 807-12. pmid: 12376441 PubMed
  25. Vestergaard P, Mosekilde L. Cohort study on effects of parathyroid surgery on multiple outcomes in primary hyperparathyroidism. BMJ 2003; 327: 530-534. pmid: 12958111 PubMed
  26. Vestergaard P, Mosekilde L. Parathyroid surgery is associated with a decreased risk of hip and upper arm fractures in primary hyperparathyroidism: a controlled cohort study. J Intern Med 2004; 255: 108-14. PubMed
  27. Silverberg SJ, Brown I, Bilezikian JP. Age as a criterion for surgery in primary hyperparathyroidism. Am J Med 2002; 113: 681-4. PubMed
  28. Eigelberger MS, Cheah WK, Ituarte PH et al. The NIH criteria for parathyroidectomy in asymptomatic primary hyperparathyroidism: are they too limited? Ann Surg 2004; 239: 528-35. PubMed
  29. Bollerslev J, Varhaug JE, Falch J. Marginal primær hyperparatyreoidisme. Tidsskr Nor Lægeforen 1999; 19: 3290-3. PubMed
  30. Palazzo FF, Sadler GP, Reene TS. Minimally invasive parathyroidectomy. BMJ 2004; 328: 849-50. PubMed
  31. Lundgren E, Lind L, Palmer M, Jakobsson S, Ljunghall S, Rastad J. Increased cardiovascular mortality and normalized serum calcium in patients with mild hypercalcaemia followed up for 25 years. Surgery 2001;130: 978-85. PubMed
  32. Ogard CG, Engholm G, Almdal TP et al. Increased mortality in patients hospitalized with primary hyperparathyroidism during the period 1977-1993 in Denmark. World J Surg 2004; 28: 108-11. PubMed
  33. Bilezikian JP, Brandi ML, Eastell R, et al. Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fourth International Workshop. J Clin Endocrinol Metab 2014; 99: 3561-9. pmid:25162665 PubMed
Annonse
Annonse