Altered copper and zinc metabolism in primary hyperparathyroidism.

Mean 24-hour urinary excretion of copper and zinc was greater than normal in 17 patients with untreated primary hyperparathyroidism. Mean total serum copper concentration in these patients was slightly greater than the normal mean, whereas mean total zinc concentration was normal. After surgical treatment of hyperparathyroidism there was a transient further increase in urinary copper and zinc concentrations in the 13 patients so studied, with no consistent change in serum copper or zinc concentrations. Five patients were studied for several days after this postoperative peak had passed. Urinary copper and zinc excretion decreased in three in relation to surgical correction of their hyperparthyroidism and remained elevated in one with persistent hypercalcemia. In the fifth patient urinary zinc excretion increased to slightly above the normal range despite successful surgery. These results suggest that changes in urinary excretion of copper and zinc may be useful indicators in the diagnosis and treatment of patients with primary hyperparathyroidism.