Normocalcemic hyperparathyroidism. Biochemical and symptom profiles before and after surgery
A. E. Siperstein, W. Shen, A. K. Chan, Q. Y. Duh and O. H. Clark
Department of Surgery, University of California, San Francisco 94120.
Patients with normocalcemic hyperparathyroidism represent a diagnostic and
therapeutic challenge. It is unclear to what extent these patients benefit
from surgery in terms of correction of their serum chemistry abnormalities
and their symptoms. We studied 142 patients: 23 with normocalcemic
hyperparathyroidism (serum calcium levels below 2.62 mmol/L), 35 with
intermittent hypercalcemia, and 84 with hypercalcemic hyperparathyroidism.
Serum chemistry analyses and a standardized questionnaire of symptoms were
completed before and after surgery. Overall, patients in the normocalcemic
group reported a similar frequency of preoperative symptoms; had a similar
reduction in postoperative symptoms; and had a similar normalization of
serum calcium, parathormone, and phosphate levels as those in the two
control groups. This study indicates that factors other than elevated serum
calcium levels are in large part responsible for the symptoms of
hyperparathyroidism and that these patients benefit from operation.
