Primary hyperparathyroidism. Changing clinical spectrum, prevalence of hypertension, and discriminant analysis of laboratory tests

Abstract

The clinical spectrum of 100 consecutive cases of surgically proved primary hyperparathyroidism treated from 1974-1978 was analyzed. Their laboratory test results were compared with 64 cases of other forms of hypercalcemia using multivariate discriminant analysis. The clinical spectrum has dramatically shifted during the past 3 decades from renal calculi and bone disease to the asymptomatic patient discovered by routine serum chemical analysis. Hypertension was twice as common among hyperparathyroid patients as in the general population but failed to improve in 92% after parathyroidectomy. The most useful discriminant laboratory tests in descending order of value were the serum Cl, serum Ca, hematocrit [Hct], serum phosphorus and parathormone. Multivariate discriminant analysis of the serum Ca, P, Cl, and Hct provided a 98% degree of accuracy in separation hyperparathyroidism from other forms of hypercalcemia.