The Parathyroid Adenoma

Dr. William Clark, Junior Assistant Resident in Medicine, Jewish Hospital of St. Louis, and Assistant in Medicine, Washington University School of Medicine: The patient is a 68-year-old retired white woman who entered Jewish Hospital for the fourth time on June 27, 1967, with the chief complaint of abdominal pain. In October 1964 she had been admitted because of gastrointestinal bleeding attributed to indomethicin therapy for osteoarthritis, and a gastric ulcer was found roentgenographically. On reexamination four months later, the ulcer had completely healed. The patient had been essentially asymptomatic until one month before the present admission when she experienced recurrent burning epigastric pain, weight loss, and fatigue. The patient also had had hypertension and severe bitemporal headaches for many years which persisted despite therapy. Blood pressure in both arms was 200 mm Hg systolic and 100 mm Hg diastolic in the recumbent position, and her pulse was regular at 80