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Many patients are diagnosed with primary hyperparathyroidism when mild hypercalcemia is discovered incidentally. Observation is considered acceptable for such patients if they are asymptomatic and serum calcium is only mildly elevated. However, some clinicians believe that many “asymptomatic” patients actually have subtle symptoms and would benefit from surgery.
In this Scandinavian trial, 191 patients with mild, presumably asymptomatic, hyperparathyroidism (mean serum calcium, 10.8 mg/dL) were randomized to observation or to parathyroidectomy. The authors provide data for the first 99 patients to have completed 1- and 2-year follow-up visits, at which quality of life was monitored using standardized surveys. Although a few minor differences…