Hyperparathyroidism

Clinical Experiences from 208 Cases

Abstract

A clinical series of 208 patients with primary hyperparathyroidism diagnosed between 1958 and 1971 is reviewed. Part of this series has been reported earlier and this gives us a possibility to compare the early part of the series seen between 1958 and 1967 and the more recent part observed between 1968 and 1971. The frequency of diagnosed HPT in patients from the service area of the University Hospital of Uppsala gives a calculated minimum prevalence of 1/1 000 in the age groups above 40. The series of HPT is still dominated by patients with urinary tract symptoms. This is to some extent due to thorough screening of all patients with urinary calculi especially with recurrent stones. An increasing number of patients, however, present themselves with unspecific symptoms or symptoms simulating other diseases. In the diagnosis determination of the serum calcium is of main importance. Many cases are found accidentally through serum calcium determinations made routinely. The only biochemical test of additional decisive diagnostic value was the calcium infusion test ad modum Kyle. During recent years patients with recurrent kidney stones have been explored even if normocalcemic. Among these patients with positive findings the microscopic picture was in about 60 per cent that of hyperplasia. The experiences from this series indicate that in adenomatous HPT, removal of adenomatous tissue, leaving non-adenomatous glands intact, seems to be effective. A few cases of recurrence are supposed to be due to incomplete exploration.