An elevated blood calcium is detected frequently because of routine blood testing. However even when the blood calcium is elevated many patients are not investigated to exclude hyperparathyroidism and the diagnosis may be delayed for years.
A recent report from the Cleveland Clinic showed that only about 1% of patients with hyperparathyroidism were properly diagnosed and only 0.3% of those diagnosed were treated by surgery, despite many of these patients having the criteria for surgical treatment.
There are guidelines for recommending surgery in hyperparathyroidism and they include any patient with symptoms ( see later slide), and patients without apparent symptoms if:
- The calcium is more than 1 mg/100ml above normal.
- There is evidence of decreased bone density
- There is evidence of kidney damage