October 1962

Unusual Cases of Hyperparathyroidism

Author Affiliations


National Heart Institute Research Fellow, Department of Medicine (Dr. Pearl); Professor of Pathology, Department of Pathology (Dr. Sternberg); Formerly Associate Professor of Medicine; Director, Division of Endocrinology, Tulane University School of Medicine; Chief, Tulane Endocrine Clinic, Charity Hospital of Louisiana (Dr. Dingman).; Present address of Dr. Dingman: Frank H. Lahey Foundation, Metabolic Research Unit, Robert B. Brigham Hospital, Boston.; From the Departments of Medicine and Pathology, Tulane University School of Medicine and Charity Hospital of Louisiana.

Arch Intern Med. 1962;110(4):481-492. doi:10.1001/archinte.1962.03620220073013

The clinical spectrum of primary hyperparathyroidism has been greatly broadened in recent years. Initially this disease was recognized only by the presence of osteitis fibrosa cystica generalisata.1 In 1925 Mandl was the first to excise a parathyroid tumor in a patient with classical skeletal changes.2 Albright and his associates subsequently showed that hyperparathyroidism was more commonly associated with kidney stones.1 More recent studies have shown an association of hyperparathyroidism with peptic ulcers,3-8 pancreatitis,9-11 steatorrhea,12 multiple endocrine adenomas,13-15 and a multitude of clinical signs and symptoms secondary to the hyperparathyroid state.4,7

An accurate diagnosis of primary hyperparathyroidism can be made only by correlation of the clinical findings and laboratory studies. Unfortunately, there is no direct test for parathyroid gland activity, and laboratory studies depend upon indirect procedures such as the determination of serum calcium and inorganic phosphorus and the various tests of phosphate

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