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August 9, 1976

Primary Hyperparathyroidism With 31 Years of Hypercalcemia

Author Affiliations

From the departments of pathology (Drs Kosinski and Roth) and medicine (Dr Chapman), Harvard Medical School, Cambridge, Mass, and the Massachusetts General Hospitals, Boston. Dr Roth is now at the Department of Pathology, University of Arkansas College of Medicine, Little Rock, Ark.

JAMA. 1976;236(6):590-591. doi:10.1001/jama.1976.03270060040027

BIOCHEMICAL screening during the course of routine medical examinations has led to the discovery of increasing numbers of patients with asymptomatic primary hyperparathyroidism.1,2 There is a paucity of clinical data as to the natural history of primary hyperparathyroidism, and though recent studies,2,3 as well as Robert Neer, MD, in an oral communication (Jan 2, 1976), have indicated that a significant number of these patients may be observed without danger, many physicians feel obligated to operate on these asymptomatic individuals in order to correct the biochemical abnormality. There have been numerous reports of patients whose first symptom of primary hyperparathyroidism, usually a renal stone, has occurred as much as 40 years prior to the establishment of the diagnosis of primary hyperparathyroidism and the treatment of this disease.4,5 Fahey and Meyers6 reported a patient with chemically proved hypercalcemia of 36 years' duration that persisted 30 years after removal