To the Editor.—
The widespread use of multichannel screening tests has been responsible for identifying an increasingly large group of patients with mild hypercalcemia and no symptoms. These patients often present a therapeutic problem, because it is not known in which ones progressive disease will develop and in ones there will be no symptoms. Kosinski and colleagues (236:590, 1976) have recently described 31 years of welldocumented primary hyperparathyroidism in a patient who remained asymptomatic during this period. Other isolated reports have confirmed that there appears to be a subset of patients with primary hyperparathyroidism whose natural history is not associated with progressive targetorgan dysfunction.In contrast, we recently cared for a patient whose case illustrates that long-standing primary hyperparathyroidism may be progressive although she was asymptomatic for more than three decades.
Report of a Case.—
A female patient was admitted to the Stamford Hospital on three separate occasions in 1943
Antman EM, Bilezikian JP. Asymptomatic Hyperparathyroidism. JAMA. 1977;237(20):2186–2187. doi:10.1001/jama.1977.03270470022004
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