Recent contributions1 to the subject of hyperparathyroidism have stressed the necessity to consider the entire clinical and laboratory picture of the disease rather than to place too much reliance on any isolated observation or group of observations. The so-called metabolic criteria of hyperparathyroidism may be duplicated in conditions in which there is no evidence of hyperfunction of the parathyroids.2 Likewise in proved cases of hyperparathyroidism the metabolic criteria may be absent. Gutman1 has noted that, of seventy-eight reported cases of hyperparathyroidism in which determinations of serum calcium were recorded, 25 per cent failed to show a consistent hypercalcemia. This case of osteitis fibrosa cystica generalisata is reported as an instance of probable hyperparathyroidism fulfilling all the clinical and roentgenographic criteria of the condition with, nevertheless, consistently normal concentrations of calcium and phosphorus in the serum.
Mrs. M. C. was first admitted to the New Haven hospital in 1922, when she
Robbins CL. OSTEITIS FIBROSA CYSTICA AND RENAL CALCULI WITHOUT HYPERCALCEMIA. JAMA. 1935;104(2):116–117. doi:10.1001/jama.1935.92760020001009a
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