The diagnosis of pHPT Is not always straight forward and for this reason it is worth pursuing an opinion from an experienced endocrine surgeon. Investigation generally involves simple blood tests to confirm biochemical results consistent with pHPT. Analysis of urine samples may also be necessary to assist with regard to the diagnosis and to exclude other problems. For most patients, the presence of obvious disease is evident on blood tests but they sometimes require repeating over time when the diagnosis is in doubt. At this stage, additional tests may be requested to clarify of there are any associated problems with bone health or kidney function.
Once the diagnosis is confirmed, your endocrine surgeon will discuss management with you. In essence, the only way to cure the problem is an operation to excise the diseased glands in the neck. In order to assist with the surgical plan, scans of the neck will be required. It is Professor Gundara’s preference to have a neck ultrasound and nuclear medicine scan performed to help localise the disease in the neck. He will often complete the ultrasound himself during your consultation. Occasionally, a dedicated CT scan will be required. The primary aim of these scans is to assist in localisation of the problematic gland/s. If successful, this can facilitate a minimally invasive operation to cure the problem quickly and with a reduced risk of complications.
Hyperparathyroidism Guidelines
Recently, Professor Gundara’s expertise in this area was recognised by being the only Queensland clinician invited to contribute to the drafting and publication of the first ever bi-national (Aust and NZ) Guidelines for the Management of Hyperparathyroidism. After 18 months of work with fellow experts from around Australia and New Zealand these guidelines were published recently in Clinical Endocrinology:
Milat, F., Ramchand, S., Herath, M., Gundara, J.S., Harper, S., Farrell, S., Girgis, C., Clifton-Bligh, R., Schneider, H., De Sousa, S., Gill, A.J., Serpell, J., Taubman, K., Christie, J., Carroll, R., Miller, J., Grossmann, M. (2021) Primary hyperparathyroidism in adults – (Part I) assessment and medical management: Position statement of the endocrine society of Australia, the Australian & New Zealand endocrine surgeons, and the Australian & New Zealand bone and mineral society. Clinical Endocrinology; in press.
Miller, J., Gundara, J.S., Harper, S., Herath, M., Ramchand, S., Farrell, S., Serpell, J., Taubman, K., Christie, J., Girgis, C., Schneider, H., Clifton-Bligh, R., Gill, A.J., De Sousa, S., Carroll, R., , Grossmann, M., Milat, F. (2021) Primary hyperparathyroidism in adults – (Part II) surgical management and postoperative follow-up: Position statement of the endocrine society of Australia, the Australian & New Zealand endocrine surgeons, and the Australian & New Zealand bone and mineral society. Clinical Endocrinology; in press.
