Primary hyperparathyroidism.

Treatment of primary hyperparathyroidism depends on a clear diagnosis based on biochemical confirmation. Most patients have an elevated serum total or ionized calcium level in association with an elevated or inappropriate serum intact parathyroid hormone level. The serum calcium level can be lowered by hydration and by a variety of pharmacologic agents. However, none of these agents is effective in the long-term management of primary hyperparathyroidism. The extraordinarily high success rate of surgery, combined with its low morbidity and the ever-increasing acceptance of minimally invasive techniques, makes surgical resection the recommended treatment for virtually all patients.