Primary Hyperparathyroidism of Postmenopausal Women

Abstract

Primary hyperparathyroidism (HPT) today is a common endocrine disease, which has been diagnosed with an increasing incidence during the recent decades (Heath et al. 1980, Palmer et al. 1988A, Bilezikian et al. 1994). Over time the characteristic mode of clinical presentation of HPT has changed from that of pronounced hypercalcemia accompanied by threatening complications to a seemingly innocuous disorder with few or no apparent symptoms (Bilezikian et al. 1994). Moreover postmenopausal females have become the largest subgroup of patients subjected to treatment of the disorder (herstrom et al. 1986A). The earliest patients with HPT came to medical attention because of a severe bone disease, and it was soon discovered that many patients with HPT also had recurrent nephrolithiasis (Albright & Reifenstein 1948). Since most stone forming patients seemed to lack marked skeletal symptoms and since they usually had less pronounced hypercalcemia and neurological complications, it was suggested that there were two distinct types of primary HPT. Type I was characterised by large parathyroid glands, bone disease and severe, symptomatic hypercalcemia, while HPT type I1 related to smaller glands and a propensity to the formation of renal stones (Lloyd 1968).