PMID- 34863037 OWN - NLM STAT- MEDLINE DCOM- 20220520 LR - 20220613 IS - 1479-683X (Electronic) IS - 0804-4643 (Print) IS - 0804-4643 (Linking) VI - 186 IP - 2 DP - 2022 Feb 1 TI - European Expert Consensus on Practical Management of Specific Aspects of Parathyroid Disorders in Adults and in Pregnancy: Recommendations of the ESE Educational Program of Parathyroid Disorders. PG - R33-R63 LID - EJE-21-1044.R1 [pii] LID - 10.1530/EJE-21-1044 [doi] AB - This European expert consensus statement provides recommendations for the diagnosis and management of primary hyperparathyroidism (PHPT), chronic hypoparathyroidism in adults (HypoPT), and parathyroid disorders in relation to pregnancy and lactation. Specified areas of interest and unmet needs identified by experts at the second ESE Educational Program of Parathyroid Disorders (PARAT) in 2019, were discussed during two virtual workshops in 2021, and subsequently developed by working groups with interest in the specified areas. PHPT is a common endocrine disease. However, its differential diagnosing to familial hypocalciuric hypercalcemia (FHH), the definition and clinical course of normocalcemic PHPT, and the optimal management of its recurrence after surgery represent areas of uncertainty requiring clarifications. HypoPT is an orphan disease characterized by low calcium concentrations due to insufficient PTH secretion, most often secondary to neck surgery. Prevention and prediction of surgical injury to the parathyroid glands are essential to limit the disease-related burden. Long-term treatment modalities including the place for PTH replacement therapy and the optimal biochemical monitoring and imaging surveillance for complications to treatment in chronic HypoPT, need to be refined. The physiological changes in calcium metabolism occurring during pregnancy and lactation modify the clinical presentation and management of parathyroid disorders in these periods of life. Modern interdisciplinary approaches to PHPT and HypoPT in pregnant and lactating women and their newborns children are proposed. The recommendations on clinical management presented here will serve as background for further educational material aimed for a broader clinical audience, and were developed with focus on endocrinologists in training. FAU - Bollerslev, Jens AU - Bollerslev J AD - J Bollerslev, Section of Specialized Endocrinology, Department of Endocrinology, Medical Clinic, Oslo University Hospital, Oslo, Norway. FAU - Rejnmark, Lars AU - Rejnmark L AD - L Rejnmark, Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, 8000, Denmark. FAU - Zahn, Alexandra AU - Zahn A AD - A Zahn, Department of Endocrine Surgery, Schon Klinik Hamburg-Eilbek, Hamburg, Germany. FAU - Heck, Ansgar AU - Heck A AD - A Heck, Section for Specialised Endocrinology, Department of Endocrinology, Medical Clinic, Oslo University Hospital, Rikshospitalet, Oslo, Norway. FAU - Appelman-Dijkstra, N M AU - Appelman-Dijkstra NM AD - N Appelman-Dijkstra, Department of Medicine; Division of Endocrinology, LUMC, Leiden, Netherlands. FAU - Cardoso, Luis AU - Cardoso L AD - L Cardoso, Instituto de Investigacao e Inovacao em Saude da Universidade do Porto, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal. FAU - Hannan, Fadil M AU - Hannan FM AD - F Hannan, Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland. FAU - Cetani, Filomena AU - Cetani F AD - F Cetani, Endocrinology and Metabolism, University of Pisa, Pisa, 56124, Italy. FAU - Sikjaer, Tanja AU - Sikjaer T AD - T Sikjaer, Department of Endocrinology and Internal Medicine, Aarhus Universitetshospital, Aarhus, Denmark. FAU - Formenti, Anna Maria AU - Formenti AM AD - A Formenti, Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, Milano, Italy. FAU - Bjornsdottir, Sigridur AU - Bjornsdottir S AD - S Bjornsdottir, Department of Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. FAU - Schalin-Jantti, Camilla AU - Schalin-Jantti C AD - C Schalin-Jantti, Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. FAU - Belaya, Zhanna AU - Belaya Z AD - Z Belaya, neuroendocrinology and bone disease, The National Research Center for Endocrinology, Moscow, 117036, Russian Federation. FAU - Gibb, Fraser Wilson AU - Gibb FW AD - F Gibb, Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland. FAU - Lapauw, Bruno AU - Lapauw B AD - B Lapauw, Endocrinology, Ghent University Hospital, Ghent, B-9000, Belgium. FAU - Amrein, Karin AU - Amrein K AD - K Amrein, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria. FAU - Wicke, Corinna AU - Wicke C AD - C Wicke, Thyroid Center, Luzerner Kantonsspital, Luzern, Switzerland. FAU - Grasemann, Corinna AU - Grasemann C AD - C Grasemann, Department of Pediatrics, Ruhr University of Bochum Faculty of Medicine, Bochum, Germany. FAU - Krebs, Michael AU - Krebs M AD - M Krebs, Internal Medicine III, Div. Endocrinology, Medical University of Vienna, Vienna, 1090, Austria. FAU - Ryhanen, Eeva M AU - Ryhanen EM AD - E Ryhanen, Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. FAU - Makay, Ozer AU - Makay O AD - O Makay, general surgery, ege university, izmir, 35100, Turkey. FAU - Minisola, Salvatore AU - Minisola S AD - S Minisola, Department of Internal Medicine and Medical Disciplines, "Sapienza" University of Rome, Rome, 00161, Italy. FAU - Gaujoux, Sebastien AU - Gaujoux S AD - S Gaujoux, Digestive and Endocrine surgery, Hopital Cochin, Paris, France. FAU - Bertocchio, Jean-Philippe AU - Bertocchio JP AD - J Bertocchio, Nephrology department,, Assistance Publique-Hopitaux de Paris (AP-HP), Pitie-Salpetriere Hospital, Boulevard de l'Hopital, 75013 Paris , France. FAU - Hassan-Smith, Zaki K AU - Hassan-Smith ZK AD - Z Hassan-Smith, Department of Endocrinology; University Hospitals Birmingham, University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland. FAU - Linglart, Agnes AU - Linglart A AD - A Linglart, Pediatric endocrinology, APHP, Bicetre Paris-Sud Hospital, Le Kremlin Bicetre, 94270, France. FAU - Winter, Elizabeth M AU - Winter EM AD - E Winter, Department of Medicine; Division of Endocrinology, Leiden University Medical Center, Leiden, Netherlands. FAU - Kollmann, Martina AU - Kollmann M AD - M Kollmann, Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria. FAU - Zmierczak, Hans-Georg AU - Zmierczak HG AD - H Zmierczak, Reference centre for rare bone, calcium and phosphate disorders, Ghent Universitary Hospital, Ghent, Belgium. FAU - Tsourdi, Elena AU - Tsourdi E AD - E Tsourdi, Division of Endocrinology, Diabetes, and Bone Diseases, Dresden Technical University Medical Center , Dresden, 01307, Germany. FAU - Pilz, Stefan AU - Pilz S AD - S Pilz, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria. FAU - Siggelkow, Heide AU - Siggelkow H AD - H Siggelkow, Endokrinologikum Gottingen, Georg-August-University Gottingen, Gottingen, Germany. FAU - Gittoes, Neil J AU - Gittoes NJ AD - N Gittoes, Department of Endocrinology; University Hospitals Birmingham , University of Birmingham, Birmingham, United Kingdom of Great Britain and Northern Ireland. FAU - Marcocci, Claudio AU - Marcocci C AD - C Marcocci, Clinical and Experimental Medicine, University of Pisa, Pisa, 56124, Italy. FAU - Kamenicky, Peter AU - Kamenicky P AD - P Kamenicky, Centre de Reference des Maladies Rares de l'Hypophyse, Le Kremlin-Bicetre, Ile-de-France, France. CN - 2021 PARAT Working Group LA - eng PT - Journal Article DEP - 20220113 PL - England TA - Eur J Endocrinol JT - European journal of endocrinology JID - 9423848 RN - 0 (Parathyroid Hormone) RN - SY7Q814VUP (Calcium) SB - IM MH - Adult MH - Calcium MH - Female MH - Humans MH - *Hypercalcemia/complications MH - *Hyperparathyroidism, Primary/complications/diagnosis/therapy MH - *Hypoparathyroidism/diagnosis MH - Infant, Newborn MH - Lactation MH - *Parathyroid Diseases MH - Parathyroid Hormone MH - Pregnancy PMC - PMC8789028 FIR - Zillikens, Carola IR - Zillikens C FIR - Frost, Morten IR - Frost M FIR - Rolighed, Lars IR - Rolighed L FIR - Sitges-Serra, Antonio IR - Sitges-Serra A FIR - Corbetta, Sabrina IR - Corbetta S FIR - Decallonne, Brigitte IR - Decallonne B FIR - Gherlan, Iuliana IR - Gherlan I FIR - Gianotti, Laura IR - Gianotti L FIR - Grigorie, Daniel IR - Grigorie D FIR - Hindie, Elif IR - Hindie E FIR - Kiely, Mairead IR - Kiely M FIR - Lindner, Kirsten IR - Lindner K FIR - Makras, Polyzios IR - Makras P FIR - Obermayer-Pietsch, Barbara IR - Obermayer-Pietsch B FIR - Perez-Lopez, Fastino R IR - Perez-Lopez FR FIR - Pretorius, Mikkel IR - Pretorius M FIR - Saponaro, Federica IR - Saponaro F FIR - Trummer, Christian IR - Trummer C FIR - Vamvakidis, Kyriakos IR - Vamvakidis K FIR - Vashakmadze, Natia IR - Vashakmadze N FIR - Yavropoulou, Maria P IR - Yavropoulou MP EDAT- 2021/12/05 06:00 MHDA- 2022/05/21 06:00 PMCR- 2022/01/25 CRDT- 2021/12/04 17:02 PHST- 2021/12/01 00:00 [aheadofprint] PHST- 2021/10/13 00:00 [received] PHST- 2021/12/03 00:00 [accepted] PHST- 2021/12/05 06:00 [pubmed] PHST- 2022/05/21 06:00 [medline] PHST- 2021/12/04 17:02 [entrez] PHST- 2022/01/25 00:00 [pmc-release] AID - EJE-21-1044.R1 [pii] AID - EJE-21-1044 [pii] AID - 10.1530/EJE-21-1044 [doi] PST - epublish SO - Eur J Endocrinol. 2022 Jan 13;186(2):R33-R63. doi: 10.1530/EJE-21-1044. Print 2022 Feb 1.