Clinical Primary Hyperparathyroidism

Introduction  The entity of primary hyperparathyroidism is relatively new. It has been only 33 years (1925) since Mandle ¹ first removed a parathyroid adenoma from a patient with osteitis fibrosa generalisata and established a relationship of skeletal disease to parathyroid function. For many years hyperparathyroidism was recognized only by skeletal findings of osteitis fibrosa or von Recklinghausen's disease. It was not until 1929 that Albright, Bauer, Ropes, and Aub² showed that the commonest clinical manifestation of hyperparathyroidism was kidney stones.Because of its relatively recent clinical recognition, all of the various manifestations of this disease are not always obvious. At Duke Hospital,³ over a 25-year period, 17 cases were diagnosed in the first 24 years and 10 cases in the next 1 year.In the past four years we have identified seven cases of hyperparathyroidism resulting from single adenomas and one with multiple adenomas, in which the presenting