Primary Hyperparathyroidism

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Abstract
Severe hypercalcemia was induced in 10 patients with primary hyperparathyroidism. In seven with parathyroid adenomas, no change occurred in serum parathyroid hormone (PTH), as measured by a highly sensitive and reproducible radioimmunoassay. Serum PTH was suppressed in three patients with primary chief-cell hyperplasia, whose pattern of suppression was closely comparable to that observed in normal subjects and in patients with secondary hyperparathyroidism. Primary hyperplasia appears to be a more common pathologic entity than the literature suggests. Measurement of serum PTH before and after massage of either side of the neck permits preoperative localization of hyperfunctioning glands.