ReviewJBMR plus2020
Normocalcemic Hyperparathyroidism: A Heterogeneous Disorder Often Misdiagnosed?
Review in JBMR plus, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Unravelling the link between chronic inflammation and primary hyperparathyroidism: a systematic review.Frontiers in immunology · 2025Pooled it
- Italian Guidelines for the Management of Sporadic Primary Hyperparathyroidism.Endocrine, metabolic & immune disorders drug targets · 2024Guideline
- A comparative analysis of osteoporosis, nephrolithiasis, and metabolic/cardiovascular comorbidities in normocalcemic and mild primary hyperparathyroidism.Journal of bone and mineral metabolism · 2026Article
- Prevalence and determinants of secondary hyperparathyroidism: IMOS-2021.Scientific reports · 2026Article
- Effects of Normocalcemic Hyperparathyroidism on Structural Bone Compromise: A Prospective Observational Cohort Study.Journal of bone metabolism · 2026Article
- Parathyroid histology in normocalcemic and hypercalcemic primary hyperparathyroidism with hypercalciuric renal stones.Journal of the Endocrine Society · 2026Article
- Kidney stone recurrence in hypercalcemic and normocalcemic primary hyperparathyroidism without parathyroidectomy.Endocrine connections · 2025Article
- Indications for primary aldosteronism screening in people with hypertension and hyperparathyroidism: a multi-centre cohort study.Endocrine · 2025Article
- Unraveling the Paradox of Vitamin D Status in Primary Hyperparathyroidism: An Incidental Finding or an Unexpected Consequence?International journal of molecular sciences · 2025Article
- Intraoperative Parathyroid Hormone Monitoring Criteria in Primary Hyperparathyroidism: A Network Meta-Analysis of Diagnostic Test Accuracy.JAMA otolaryngology-- head & neck surgery · 2025Article
- The predictive value of 24-hour urinary calcium for kidney stone risk in primary hyperparathyroidism: insight from a retrospective study of parathyroid adenoma cases.Frontiers in endocrinology · 2025Article
- Osteoporosis and Normocalcemic Primary Hyperparathyroidism (Conservatively or Surgically Managed).Journal of clinical medicine · 2024Review
- Comparison of Normocalcemic vs Hypercalcemic Primary Hyperparathyroidism in a Hypercalciuric Renal Stone Population.The Journal of clinical endocrinology and metabolism · 2024Article
- Sporadic Parathyroid Adenoma: A Pilot Study of Novel Biomarkers in Females.Medicina (Kaunas, Lithuania) · 2024Article
- Natural history and complications of normocalcemic hyperparathyroidism: a retrospective cohort study.JBMR plus · 2024Article
- Secular trends in the incidence and treatment patterns of primary hyperparathyroidism in Korea: a nationwide cohort study.JBMR plus · 2024Article
- Age-specific Reference Intervals of Abbott Intact PTH-Potential Impacts on Clinical Care.Journal of the Endocrine Society · 2024Article
- Dietary calcium intake in primary hyperparathyroidism and in its normocalcemic variant: a case-control study.Frontiers in endocrinology · 2024Article
- Incidental Normocalcemic Primary Hyperparathyroidism Presenting With Symptomatic Hypophosphatemia: A Case Report.Cureus · 2023Article
- The Eucalcemic Patient With Elevated Parathyroid Hormone Levels.Journal of the Endocrine Society · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Normocalcemic primary hyperparathyroidism (NHPT) was first described over 10 years ago, but uncertainties still remain about its definition, prevalence, and rates of complications. As a result, consensus management guidelines for this condition have not yet been published. Several hypotheses have been proposed for the pathophysiology of NHPT, but it may be a heterogeneous disorder with multiple causes, rather than a single etiology that explains this biochemical phenotype. A common clinical concern is whether NHPT should be treated surgically when complications are already present at first recognition of the disorder, rather than following patients clinically over time. The literature on NHPT is based mostly on larger studies of population-based cohorts and smaller studies from referral centers. Lack of rigorous diagnostic criteria and selection bias inherent in populations seen at tertiary referral centers may explain the heterogeneity of reported rates of bone and renal complications in relation to consistently mild laboratory alterations. Unresolved questions remain about the significance of NHPT when it is diagnosed biochemically without evident bone or kidney complications. Moreover, its natural history remains to be elucidated because a proportion of what is classified as NHPT may revert to normal spontaneously, thus revealing previously unrecognized secondary hyperparathyroidism. These issues indicate that caution should be used in recommending surgery for NHPT. This review will focus on recent issues regarding the pathophysiology, evaluation, and management of NHPT. © 2020 The Authors.
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Registered trials
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