Primary Hyperparathyroidism

Abstract

To achieve preoperative localization of abnormal parathyroid tissue in 33 patients suspected of having primary hyperparathyroidism, blood samples were obtained before operation by catheter from the small veins of the thyroid venous plexus. Parathyroid hormone concentrations in the samples were determined by radioimmunoassay. The correctness of the predicted lateralization was confirmed in all 21 patients who were operated on. A unilateral hormone gradient was seen in patients who had a single adenoma; bilateral gradients were seen in those who had multiple abnormal glands. The technic seems useful for localizing the site of abnormal parathyroid tissue, for preoperative differentiation of a single abnormal gland (adenoma) from multiple abnormal glands (hyperplasia), and it also may be helpful in establishing the existence of hyperparathyroidism in certain patients who pose special diagnostic problems.