PRIMARY HYPERPARATHYROIDISM OBSERVATIONS IN A SERIES OF 50 CASES

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Abstract
In a series of cases of hyperparathyroidism more than 60% were diagnosed, as this condition is common in patients with renal calculi. In 74% there was radiologically demonstrable calcification or true concretions. Giant cell tumors were present in 8 and duodenal ulcer in 7 cases. The blood Ca was not necessarily raised. In nearly every case renal damage was present, even if radiological-ly undemonstrable. The renal damage was thought to be primarily a tubular lesion, resulting mainly in a decrease in concentration capacity. In early cases the renal lesion was of a functional nature and disappeared after parathyroidectomy; in more advanced cases it became structural and regressed only partially after operation. Hypertension was frequently present; in early cases it was moderate and transitory, but became severe and stationary in more advanced cases. Coexistent changes in the parathyroid and thyroid glands occurred in 41% of the cases. The pathological change in the thyroid usually produced small adenomas but also nodular and diffuse goiter. The prognosis of untreated hyperparathyroidism is doubtful.

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