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Response to: Hypercalcemia with a parathyroid hormone level of ≤50 pg/mL: Is this primary hyperparathyroidism?

Published:December 29, 2022DOI:https://doi.org/10.1016/j.surg.2022.11.028
      We appreciate the attention Sharma et al has paid to our article, "Hypercalcemia with a parathyroid hormone level of ≤50 pg/mL: Is this primary hyperparathyroidism?"

      Wang R, Abraham P, Fazendin J, Lindeman B, Chen H. Hypercalcemia with a parathyroid hormone level of ≤50 pg/mL: is this primary hyperparathyroidism [e-pub ahead of print]? Surgery. https://doi:j.surg.2022.05.043. Accessed September 11, 2022.

      Sharma et al. raised a question regarding the appropriateness of bilateral parathyroid exploration in primary hyperparathyroidism. We found that patients with hypercalcemia and parathyroid hormone (PTH) levels ≤50 pg/mL had pathology-proven hypercellular parathyroid glands and similar clinical presentation and surgical outcomes to those with PTH >50 pg/mL. Multiglandular disease was more common in patients with preoperative PTH ≤50 pg/mL than those with >50 pg/mL (58.9% vs 31.9%). Therefore, we suggested that in patients with PTH ≤50 pg/mL, surgeons should have a low threshold for bilateral parathyroid exploration.
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      References

      1. Wang R, Abraham P, Fazendin J, Lindeman B, Chen H. Hypercalcemia with a parathyroid hormone level of ≤50 pg/mL: is this primary hyperparathyroidism [e-pub ahead of print]? Surgery. https://doi:j.surg.2022.05.043. Accessed September 11, 2022.

      2. Abraham MN, Abraham PJ, Lindeman B, Chen H. Changes in imaging utilization for primary hyperparathyroidism [e-pub ahead of print]. Am Surg. https://doi.org/10.1177/00031348221074248. Accessed September 11, 2022.

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        Ambulatory bilateral neck exploration for primary hyperparathyroidism: is it safe?.
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