Primary hyperparathyroidism in Northern Sweden.

Three hundred and eleven patients with presumed hyperparathyroidism were operated upon between the years 1961 and 1983 at the two surgical clinics in Northern Sweden equipped with pathologic facilities. Eighty per cent were women. All of the patients were hypercalcemic. Parathyroid hormone (PTH) levels were elevated in 66 per cent of the patients. The correlation between serum calcium and PTH levels was only 0.38. Serum creatinine levels were normal in 92 per cent of the patients while renal concentrating ability was depressed in 79 per cent. The main patient symptoms were fatigue, mental disturbances and renal stones. Eighteen per cent were asymptomatic at the time of the operation. Most patients were diagnosed during in-hospital investigations. Many were also found to be hypercalcemic at regular outpatient controls. At operation, adenomas were found in 80 per cent, different kinds of hyperplasia in 15 per cent, normal histologic finding in 4 per cent, while cancer was found in less than 1 per cent of the patients. At follow-up study, 79 per cent were normocalcemic while 3 per cent were hypocalcemic and 11 per cent were still hypercalcemic--7.5 per cent were lost to follow-up study. Nine patients had a permanent paralysis of the recurrent laryngeal nerve.