Primary Hyperparathyroidism and the PAS Score

Primary hyperparathyroidism (PHPT), defined as an elevated serum calcium, adjusted for albumin, in conjunction with an elevated or inappropriately normal parathyroid hormone (PTH) level, is increasingly being diagnosed in patients with mild biochemical abnormalities, mostly secondary to the increased use of automated biochemical testing. The causal relationship between PHPT and neurobehavioral symptoms, including depression, anxiety, impaired cognition and memory, sleep disturbances, and reduced quality of life, has long been studied. The PAS score has indelibly transformed the evaluation and management of patients with PHPT and will remain an enduring legacy of Dr. Janice L. Pasieka's phenomenal and pioneering career.