The Appropriate Diagnosis of Primary Hyperparathyroidism.

Primary hyperparathyroidism (PHPT) is both underdiagnosed and undertreated. The most common causes for delayed diagnosis include failure to note hypercalcemia, poor workup for hypercalcemia, or not contemplating a diagnosis of HPT. Health care providers appear to overestimate the benefits of medical therapy and/or observation and underestimate the potential benefits of parathyroidectomy, as indicated by low rates of surgical referral relative to medical management. The purpose of this review is to help physicians identify, adequately diagnose, and appropriately refer the patient for surgical evaluation.