[Clinical and biochemical picture of primary hyperparathyroidism based on 155 observed cases]

In this study, the biochemical and clinical profile of primary hyperparathyroidism, diagnosed in 155 patients (106 females and 49 males) in the Department of Nephrology of the Silesian University School of Medicine in the years 1972-1998 was analyzed. The mean age of patients was 48.5 +/- 12.8 years. In all cases the diagnosis was confirmed by the pathomorphological examination. In the majority of cases PNP was diagnosed in a phase of advanced organic injuries. The leading clinical finding in these patients was nephrolithiasis. Asymptomatic hypercalcemia was diagnosed only in 9% of cases. In the years 1972-1992 elevated serum total calcium concentration was found in 92.6% while after introduction of routine estimation of ionized calcium concentration in 1993, hypercalcemia was found in all patients. The incidence of hypercalciuria increased significantly in patients diagnosed in the period 1993-1998 while in this same period the incidence of impaired renal function declined significantly. The elevated serum PTH was found in 86% of patients regardless whether C-terminal fragments of PTH or intact PTH-1-84 were assessed. Elevated levels of ionized serum calcium with normal or increased plasma iPTH-1-84 level are the most constant symptoms of primary hyperparathyroidism.