Hyperparathyroidism: Recent Studies

A review of 57 cases of primary hyperparathyroidism has delineated the changing clinical complex of the disease; its apparent prevalence increases with greater clinical awareness and more precise methods for determining serum calcium. In this series weakness and fatigability occurred just as frequently as renal colic. Relatively high prevalences of weight loss, anemia, and elevated erythrocyte sedimentation rate were not explained by abnormalities other than primary hyperparathyroidism. There was a high prevalence of muscle weakness associated with histologic changes of a neuropathic process. Angiographic methods, selective venous catheterization, and radioimmunoassay for parathyroid hormone were studied as means for localizing abnormal parathyroid tissue before surgery. Selective venous catheterization of the thyroid veins with radioimmunoassay on samples obtained allowed prediction of parathyroid tumor location in approximately 90% of cases due to adenoma; catheterization also helped predict cases due to parathyroid hyperplasia before surgery. Arteriography followed by venous sampling was valuable in cases requiring a repeat surgical exploration.