Primary hyperparathyroidism. Changing trends over fifty years.

Two groups of patients with PHPT, one (early group) operated on between 1930 and 1960, and the other (late group) from 1972 to 1981 were compared, in order to find out the changing trends in this disease during these years. The number of operated PHPT increased when serum calcium and phosphate were added to routine blood screening. The mean age of patients was lower in the early than in the late group. There was a decrease in the occurrence and severity of bone and renal disease and an increase in the number of asymptomatic patients in the late group. In the early group the serum calcium levels were higher, serum phosphate levels lower and parathyroid adenomas larger. The ratio between uni- and multiglandular parathyroid disease was similar in both groups of patients.