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Primary hyperparathyroidism. Changing trends over fifty years.

C Trigonis, B Hamberger, L O Farnebo

Acta Chirurgica Scandinavica

|January 1, 1983

Summary

Trends in primary hyperparathyroidism (PHPT) shifted significantly. Early diagnosis through blood screening led to younger patients and milder disease, with more asymptomatic cases identified in later years.

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Area of Science:

Endocrinology
Surgical History
Biochemistry

Background:

Primary hyperparathyroidism (PHPT) is a condition characterized by excessive parathyroid hormone production.
Historical trends in PHPT diagnosis and patient presentation are not well-documented.

Purpose of the Study:

To investigate changes in the clinical presentation and diagnosis of PHPT over time.
To compare patient demographics and disease characteristics between two distinct surgical eras.

Main Methods:

Retrospective analysis of two patient cohorts operated for PHPT.
Comparison of data from an early group (1930-1960) and a late group (1972-1981).
Analysis of serum calcium and phosphate levels, parathyroid adenoma size, and presence of bone and renal disease.

Main Results:

Increased PHPT surgical cases correlated with routine serum calcium and phosphate screening.
The late group had a lower mean patient age, reduced bone and renal disease severity, and more asymptomatic cases.
Early group patients exhibited higher serum calcium, lower serum phosphate, and larger parathyroid adenomas.
The ratio of uni- to multiglandular parathyroid disease remained consistent between groups.

Conclusions:

Routine blood screening has improved early detection of PHPT.
Later diagnosis and treatment of PHPT are associated with less severe clinical manifestations.
Parathyroid adenoma size and biochemical profiles differ between historical patient cohorts.

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