THE RECOGNITION OF PRIMARY HYPERPARATHYROIDISM

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Abstract
The discovery that hyperparathyroidism is the cause of generalized osteitis fibrosa cystica has led to a widespread assumption that hyperparathyroidism manifests itself only as a disease of bone.1 Because osteitis fibrosa cystica is a great rarity, it has been assumed that hyperparathyroidism is equally rare. Both of these assumptions have been proved to be false but they have nonetheless persisted. In 1934 Albright and his associates2 at the Massachusetts General Hospital reported 17 proved cases of hyperparathyroidism, most of which they had observed during a period of two years. Analysis of these cases led them to conclude that (1) hyperparathyroidism can occur without evident disease of bone, (2) involvement of the urinary tract is a more common and more important manifestation of hyperparathyroidism than involvement of the skeleton, (3) hyperparathyroidism is relatively common and (4) it is the etiologic factor in the formation of renal calculi in an