Primary hyperparathyroidism and peptic ulcer disease.

To determine whether primary hyperparathyroidism is related to peptic ulcer disease, we evaluated 46 cases of concomitant primary hyperparathyroidism and peptic ulcer disease. Among these patients, there was no sex preponderance. The pathologic findings at parathyroid surgery, as well as the features of peptic ulcer disease, were the same as in patients with primary hyperparathyroidism or with peptic ulcer disease alone. The ulcer symptoms of 58% of the patients with adequate follow up improved after parathyroidectomy. Sixty-six percent of the patients who had active peptic ulcer disease at surgery improved as compared with only 44% of the patients who had complicated peptic ulcer disease. None of the factors studied (age, sex, serum calcium and serum parathyroid hormone levels, location, and duration of ulcer) had any effect on the peptic ulcer symptoms after parathyroidectomy. Our results and a critical review of the experimental and clinical literature suggest that the association between primary hyperparathyroidism and peptic ulcer disease is no more than coincidental.