Hyperparathyroidism

Abstract

Thirty cases of primary hyperparathyroidism studied between 1956 and 1960 were reviewed with respect to the clinical spectrum, diagnostic criteria, and pathologic findings. Histologic confirmation was obtained in 24; in the remaining 6, the clinical diagnosis was unequivocal. In 4 additional cases, parathyroid adenomas were found unexpectedly. Approximately one-third of the patients did not have any symptoms of complications suggesting hyperparathyroidism. The serum calcium and phosphorus concentrations were considered to be still the most useful laboratory aids. A low tubular reabsorption of phosphate confirmed the diagnosis in all but one of the surgically proved cases. Another method of expressing renal phosphate excretion, the phosphate excretion index, appeared helpful in patients who were phosphate depleted. The majority of patients had one or more adenomas; only one case of primary chief-cell hyperplasia was uncovered. Two patients with far advanced hyperparathyroidism are described in detail.