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Osteoporosis in Primary Hyperparathyroidism: Considerations for Diagnosis and Treatment

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Medical and Surgical Treatment of Parathyroid Diseases

Abstract

Osteoporosis is a skeletal disorder produced by micro-architectural changes in bone structure that reduce bone mass and quality, resulting in a high risk of traumatic and nontraumatic fractures with significant morbidity and mortality.

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References

  1. U.S. Department of Health and Human Services. Bone health and osteoporosis. A report of the surgeon general. Rockville, MD, USA: U.S. Department of Health and Human Services; 2004. Clinical Review; Levels 1-3; Grades A-C.

    Google Scholar 

  2. Sambrook P, Cooper C. Osteoporosis. Lancet. 2006;367:17–23. Clinical Review; Levels 1-3; Grades A-C.

    Article  Google Scholar 

  3. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(11):1577–83. Population/Observational Study; Level 3; Grade A-B.

    Article  Google Scholar 

  4. Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int. 1997;7:407–13. Population/Observational Study; Level 3; Grade A-B.

    Article  CAS  PubMed  Google Scholar 

  5. Kanis JA. Diagnosis of osteoporosis and assessment of fracture risk. Lancet. 2006;359:1929–36. Expert Opinion; Level 5.

    Article  Google Scholar 

  6. Johnell O, Kanis JA. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16:S3–7. Population/Observational Study; Level 3; Grade A-B.

    Article  PubMed  Google Scholar 

  7. Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C, et al. Health-related quality of life in postmenopausal women with low BMD with or without prevalent vertebral fractures. J Bone Miner Res. 2000;15:1384–92. Clinical Investigation; Level 3; Grade A-B.

    Article  CAS  PubMed  Google Scholar 

  8. Cooper C, Atkinson EJ, Jacobsen SJ, O'Fallon WM, Melton 3rd LJ. Population-based study of survival after osteoporotic fractures. Am J Epidemiol. 1993;137:1001–5. Population/Observational Study; Level 3; Grade A-B.

    CAS  PubMed  Google Scholar 

  9. Robbins JA, Biggs ML, Cauley J. Adjusted mortality after hip fracture: from the cardiovascular health study. J Am Geriatr Soc. 2006;54:1885–91. Population/Observational Study Review; Level 3; Grades A-B.

    Article  PubMed  Google Scholar 

  10. Lewiecki EM, Gordon CM, Baim S, Binkley N, Bilezikian JP, Kendler DL, et al. Special report on the 2007 adult and pediatric position development conferences of the international society for clinical densitometry. Osteopor Int. 2008;19:1369–98. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  Google Scholar 

  11. Bonnick SL, Johnston Jr CC, Kleerekoper M, Lindsay R, Miller P, Sherwood L, Siris E. Importance of precision in bone density measurements. J Clin Densitom. 2001;4:105–10. Expert Opinion; Level 5.

    Article  CAS  PubMed  Google Scholar 

  12. Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, et al. Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet. 2001;341:72–5.

    Article  Google Scholar 

  13. Kanis JA, Burlet N, Cooper C, Delmas PD, Reginster J-Y, Borgstrom F, On behalf of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2008;19:399–428.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Schwartz AV, Vittinghoff E, Bauer DC, Hillier TA, Strotmeyer ES, Ensrud KE, Study of Osteoporotic Fractures (SOF) Research Group; Osteoporotic Fractures in Men (MrOS) Research Group; Health, Aging, and Body Composition (Health ABC) Research Group, et al. Association of BMD and FRAX score with risk of fracture in older adults with type 2 diabetes. JAMA. 2011;305:2184–92. Population/Observational Study Review; Level 3; Grades A-B.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Cummings SR, Back DM, Nevitt MC, Browner W, Cauley J, Ensrud K, et al. Bone density at various sites for predication of hip fractures. The study of osteoporotic fractures research group. Lancet. 1993;341(8837):72–5. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  16. Marshall D, Johnell O, Wedel H. Meta-analysis of how well bone mineral density predicts occurrences of osteoporotic fracture. BMJ. 1996;312:1254–9. Population/Observational Study Review; Level 3; Grades A-B.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Wainwright SA, Marshall LM, Ensrud KE, Cauley JA, Black DM, Hillier TA, et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90:2787–93. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  18. Alonso N, Ralston SH. Unveiling the mysteries of the genetics of osteoporosis. J Endocrinol Invest. 2014;37:925–34. Population/Observational Study; Level 3; Grade A.

    Article  CAS  PubMed  Google Scholar 

  19. Reid IR, Ames RW, Evans MC, Sharpe SJ, Gamble GD. Determinants of rate of bone loss in normal post menopausal women. J Clin Endocrinol Metab. 1994;79:950–4. Clinical Investigation; Level 1; Grade B.

    CAS  PubMed  Google Scholar 

  20. Kanis JA, Johnell O, Oden A, Jonsson B, De Laet C, Dawson A. Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone. 2000;27:585–90. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  PubMed  Google Scholar 

  21. National Osteoporosis Foundation. Clinicaian’s Guide to Prevention and Treatment of Osteoporosis. Washington DC: National Osteoporosis Foundation; 2010. http://www.nof.org/professionals/clinical-guidelines, Clinical Review; Levels 1-3; Grades A-C.

    Google Scholar 

  22. Heinonen A, Oja P, Kannus P, Sievänen H, Haapasalo H, Mänttäri A, et al. Bone mineral density in female athletes representing sports with different loading characteristics of the skeleton. Bone. 1997;17:197–203. Population/Observational Study; Level 2; Grade B.

    Article  Google Scholar 

  23. Lang T, LeBLanc A, Evans H, Lu Y, Genant H, Yu A. Cortical and trabecular bone loss from the spine and hip in long-duration space flight. J Bone Miner Res. 2004;19:1006–12. Population/Observational Study; Level 3; Grade A-B.

    Article  PubMed  Google Scholar 

  24. Harvey JA, Zobitz MM, Pak CY. Dose dependency of calcium absorption: a comparison of calcium carbonate and calcium citrate. J Bone Miner Res. 1998;3:253–8. Clinical Investigation; Level 1; Grade B.

    Article  Google Scholar 

  25. Elders PJ, Lips P, Netelenbos JC, van Ginkel FC, Khoe E, et al. Long-term effect of calcium supplementation on bone loss in perimenopausal women. J Bone Miner Res. 1994;9:963–70. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  26. Shea B, Wells G, Cranney A, Zytaruk N, Robinson V, Griffith L, et al. Meta-analyses of therapies for postmenopausal osteoporosis. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocr Rev. 2002;23(4):552–9. Clinical Review; Level 1; Grade C.

    Article  CAS  PubMed  Google Scholar 

  27. Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007;370:657–66. Clinical Review; Level 1; Grade C.

    Article  CAS  PubMed  Google Scholar 

  28. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2009;86:1780–90. Clinical Review; Level 1; Grade A.

    Google Scholar 

  29. Cauley JA, Robbins J, Chen Z, Cummings SR, Jackson RD, LaCroix AZ, Women’s Health Initiative Investigators, et al. Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women’s Health Initiative randomized trial. JAMA. 2003;290:1729–38. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  30. Cummings SR, Eckert S, Krueger KA, Grady D, Powles TJ, Cauley JA. The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple outcomes of raloxifene evaluation. JAMA. 1999;281:2189–97. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  31. Cummings SR, Black DM, Thompson DE, Applegate WB, Barrett-Connor E, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA. 1998;280(24):207–82.

    Article  Google Scholar 

  32. Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, FLEX Research Group, et al. Effects of continuing or stopping alendronate after 5 years of treatment: the fracture intervention trial long-term extension (FLEX): a randomized trial. JAMA. 2006;296:2927–38. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  33. Black DM, Reid IR, Cauley JA, Cosman F, Leung PC, et al. The effect of 6 versus 9 years of zoledronic acid treatment in osteoporosis: a randomized second extension to the HORIZON-pivotal fracture trial (PFT). J Bone Miner Res. 2015;30(5):934–44. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  34. Sobacchi C, Frattini A, Guerrini MM, Abinun M, Pangrazio A, Susani L, et al. Osteoclast-poor human osteopetrosis due to mutations in the gene encoding RANKL. Nat Genet. 2007;39:960–2. Population/Observational Study; Level 3; Grades A-B.

    Article  CAS  PubMed  Google Scholar 

  35. Bone HG, Bolognese MA, Yuen CK, Kendler DL, Miller PD, Yang YC, et al. Effects of denosumab treatment and discontinuation on bone mineral density and bone turnover markers in postmenopausal women with low bone mass. J Clin Endocrinol Metab. 2008;93:2149–57. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  36. Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. FREEDOM Trial. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361:756–65. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  37. Reid IR, Miller PD, Brown JP, Kendler DL, Fahrleitner-Pammer A, et al. Effects of denosumab on bone histomorphometry: the FREEDOM and STAND studies. J Bone Miner Res. 2010;25(10):2256–65. Clinical Review; Level 1; Grade A.

    Article  CAS  PubMed  Google Scholar 

  38. Shane E, Burr D, Ebeling PR, Abrahamsen B, Adler RA, Brown TD, American Society for Bone and Mineral Research, et al. Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2014;29:1–23. Clinical Review; Levels 1-3; Grades A-C.

    Article  PubMed  Google Scholar 

  39. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344:1434–41. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  40. Black DM, Greenspan SL, Ensrud KE, Palmemo L, McGowan JA, et al. The effects of parathyroid hormone and alendronate alone or in combination in postmenopausal osteoporosis. N Eng J Med. 2003;349(13):1207–15. Clinical Investigation; Level 1; Grade B.

    Article  CAS  Google Scholar 

  41. Rubin MR, Bilezikian JP, McMahon DJ, Jacobs T, Shane E, Siris E, et al. The natural history of primary hyperparathyroidism with or without parathyroid surgery after 15 years. J Clin Endocrinol Metab. 2008;93:3462–70. Population/Observational Study Review; Level 2; Grades B.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Clifton-Bligh PB, Nery ML, Supramaniam R, Reeve TS, Delbridge L, Steil JN, et al. Mortality associated with primary hyperparathyroidism. Bone. 2015;74:121–4. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  43. Steiniche T, Christiansen P, Vesterby A, et al. Primary hyperparathyroidism: bone structure, balance, and remodeling before and 3 years after surgical treatment. Bone. 2000;26:535–43. Population/Observational Study; Level 3; Grades A-B.

    Article  CAS  PubMed  Google Scholar 

  44. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis and Therapy. Osteoporosis prevention, diagnosis and therapy. JAMA. 2001;285:785–95. Clinical Review; Levels 1-3; Grades A-C.

    Article  Google Scholar 

  45. Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the fourth international workshop. J Clin Endocrinol Metab. 2014;99:3561–9. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  PubMed  Google Scholar 

  46. Bilezikian JP, Khan AA, Potts Jr JT. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop. J Clin Endocrinol Metab. 2009;94:335–9. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Marcocci C, Bollerslev J, Khan AA, Shobeck DM. Medical management of primary hyperparathyroidism: Proceedings of the fourth international workshop on the management of asymptomatic primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99:3607–18. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  PubMed  Google Scholar 

  48. Wood K, Dhital S, Chen H, Sippel RS. What is the utility of distal forearm DXA in primary hyperparathyroidism? Oncologist. 2012;17:322–5. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Lewicki EM, Baim S, Langman CB, Bilizikian JP. The official positions of the international society for clinical densitomitry; perceptions and commentary. J Clin Densitom. 2009;12:267–71. Clinical Review; Levels 1-3; Grades A-C.

    Article  Google Scholar 

  50. Kenny AM, MacGillivary DC, Pilbeam CC, Crombie HD, Raisz LG. Fracture incidence in post-menopausal women with primary hyperparathyroidism. Surgery. 1995;118:109–14. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  PubMed  Google Scholar 

  51. Khosla S, Melton 3rd LJ, Wermers RA, Corwson CS, O’Fallon WM, Riggs BL. Primary hyperparathyroidism and the risk of fracture: a population based study. J Bone Miner Res. 1999;14:1700–7. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  52. Vignali E, Viccica G, Diacinti D, Cetani F, Cianferotti L, Ambrogini E, et al. Morphometric vertebral fractures in postmenopausal women with primary hyperparathyroidism. J Clin Endocrinol Metab. 2009;94:2306–12. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. DeGeronimo S, Romoagnoli E, Diacinti D, D’Erasmo E, Minisola S. The risk of fractures in post-menopausal women with primary hyperparathyroidism. Eur J Endocrinol. 2006;155:415–20. Population/Observational Study; Level 3; Grade A-B.

    Article  CAS  Google Scholar 

  54. Cipriani C, Biamonte F, Costa AG, Zhang C, Biondi P, Diacinti D, et al. Prevalence of kidney stones and vertebral fractures in primary hyperparathyroidism using imaging technology. J Clin Endocrinol Metab. 2015;100:1309–15. Population/Observational Study; Level 3; Grade A-B.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Rao DS, Phillips ER, Divine GW, Talpos GB. Randomized controlled clinical trial of surgery versus no surgery in patients with mild asymptomatic primary hyperparathyroidism. J Clin Endocrinol Metab. 2004;89:5415–22. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  56. Ambrogini E, Catani F, Cianferotti L, Vignali E, Banti C, Vicinal G, et al. Surgery or surveillance for mild asymptomatic primary hyperparathyroidism: a prospective, randomized clinical trial. J Clin Endo Metal. 2007;92:3114–31. Clinical Investigation; Level 1; Grade B.

    Article  CAS  Google Scholar 

  57. Bollerslev J, Jannson S, Mollerup CI, Nordenstrom J, Lundgren E, Torring O, et al. Medical observation, compared with parathyroidectomy, for asymptomatic primary hyperparathyroidism: a prospective randomized clinical trial. J Clin Endocrinol Metab. 2007;92:1687–92. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  58. Silverberg SJ, Gartenberg F, Jacobs TP, Shane E, Siris E, Staron RB, et al. Increased bone mineral density after parathyroidectomy in primary hyperparathyroidism. J Clin Endo Metab. 1995;80:729–34. Population/Observational Study Review; Level 2; Grade B.

    CAS  Google Scholar 

  59. Silverberg SJ, Shane E, Jacobs TP, Siris E, Bilezikian JP. A 10-year prospective study of primary hyperparathyroidism with or without parathyroid surgery. N Engl J Med. 1999;341:1249–55. Population/Observational Study Review; Level 3; Grades A-B.

    Article  CAS  PubMed  Google Scholar 

  60. Nomura R, Sugimoto T, Tsukamoto T, Yamauchi M, Sowa H, Chen Q, et al. Marked and sustained increase in bone mineral density after parathyroidectomy in patients with primary hyperparathyroidism; a six year longitudinal study with or without parathyroidectomy in a Japanese population. Clin Endocrinol. 2004;60:335–42. Clinical Investigation; Level 3; Grade A-B.

    Article  Google Scholar 

  61. Dy BM, Grant CS, Wermers RA, Kearns AE, Huebner M, Harmsen WS, et al. Changes in bone mineral density after surgical intervention for primary hyperparathyroidism. Surgery. 2012;152:1051–8. Clinical Investigation; Level 3; Grade A-B.

    Article  PubMed  Google Scholar 

  62. Lundstam K, Heck A, Mollerup C, Godang K, Baranowski M, Pernow Y, SIPH Study Group, et al. Effects of parathyroidectomy versus observation on the development of vertebral fractures in mild primary hyperparathyroidism. J Clin Endocrinol Metab. 2015;100:1359–67. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  63. VanderWalde LH, Liu IL, O'Connell TX, Haigh PI. The effect of parathyroidectomy on bone fracture risk in patients with primary hyperparathyroidism. Arch Surg. 2006;141:885–9. Population/Observational Study; Level 3; Grades A-B.

    Article  PubMed  Google Scholar 

  64. Vestergaard P, Mollerup CL, Frøkjaer VG, Christiansen P, Blichert-Toft M, Mosekilde L. Cohort study of risk of fracture before and after surgery for primary hyperparathyroidism. BMJ. 2000;321:598–602. Population/Observational Study; Level 2; Grade B.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Marcocci C, Brandi ML, Scillitani A, Corbetta S, Faggiano A, et al. Italian Society of Endocrinology Consensus Statement: definition, evaluation and management of patients with mild hyperparathyroidism. J Endocrinol Invest. 2015;36(5):577–93. Clinical Review; Levels 1-3; Grades A-C.

    Article  Google Scholar 

  66. Marcocci C, Bollerslev J, Khan AA, Shoback DM. Medical management of primary hyperparathyroidism: proceedings of the fourth international workshop on the management of asymptomatic primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(10):3607–18. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  PubMed  Google Scholar 

  67. Chow CC, Chan WB, Li JK, Chan NN, Chan MH, Ko GT, et al. Oral alendronate increases bone mineral density in post menopausal women with primary hyperparathyroidism. J Clin Endocrinol. 2003;88:581–7. Clinical Investigation; Level 1; Grade B.

    Article  CAS  Google Scholar 

  68. Khan AA, Bilezikian JP, Kung AW, Ahmed MM, Dubois SJ, Ho AY, et al. Alendronate in primary hyperparathyroidism: a double-blind, randomized, placebo-controlled trial. J Clin Endocrinol Metab. 2004;89:3319–25. Clinical Investigation; Level 1; Grade B.

    Article  CAS  PubMed  Google Scholar 

  69. Parker CR, Blackwell PJ, Fairbarin KJ, Hoskins DJ. Alendronate in the treatment of primary hyperparathyroidism-related osteoporosis: a 2-year study. J Clin Endocrinol Metab. 2002;87:4482–9. Clinical Investigation; Level 2; Grade B.

    Article  CAS  PubMed  Google Scholar 

  70. Nemeth EF, Shoback D. Calcimimetic and calcilytic drugs for treating bone and mineral-related disorders. Best Pract Res Clin Endocrinol Metab. 2013;27:373–84. Clinical Review; Levels 1-3; Grades A-C.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Departments of Endocrinology and Otolaryngology, Oregon Health and Sciences University, 3181 Sw Sam Jackson Park Road, PV-01, Portland, OR, 97239, USA

    Dana L. Madison M.D., Ph.D.

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  1. Dana L. Madison M.D., Ph.D.
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Correspondence to Dana L. Madison M.D., Ph.D. .

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  1. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Brendan C. Stack, Jr.

  2. Department of Geniatrics and Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

    Donald L. Bodenner

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Madison, D.L. (2017). Osteoporosis in Primary Hyperparathyroidism: Considerations for Diagnosis and Treatment. In: Stack, Jr., B., Bodenner, D. (eds) Medical and Surgical Treatment of Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-26794-4_29

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