RT Journal
A1 Pasieka JL
T1 The time has come to redefine the classic symptoms of primary hyperparathyroidism: Comment on “parathyroidectomy, elevated depression scores, and suicidal ideation in patients with primary hyperparathyroidism”
JF JAMA Surgery
JO JAMA Surgery
YR 2013
FD February 1
VO 148
IS 2
SP 115
OP 116
DO 10.1001/2013.jamasurg.328
UL http://dx.doi.org/10.1001/2013.jamasurg.328
AB 
Hyperparathyroidism today is a biochemical diagnosis and diagnosed much earlier, with less than 20% of patients displaying these classic symptoms. This has led many authors to use the term asymptomatic pHPT for the remaining 80%. Yet, in the last decade, surgeons have contested that very few patients are truly asymptomatic and many benefit from surgery. At first, it was retrospective reflection by patients, claiming how much better they felt following surgery. Then came the patient-based questionnaires and generic quality of life instruments. However, plagued by small series, lack of control groups, and conflicting data from the 3 randomized trials in this field, widespread acceptance of the existence of vague neuropsychologic symptoms in pHPT and their reversibility with surgery has not been forthcoming.1