Measurement of the serum calcium is now a part of routine examinations. As a result of such profile screening, the number of patients discovered with hyperparathyroidism has increased. Still primary hyperparathyroidism is a rare disease in Korea.
Thirty
four patients with primary hyperparathyroidism were treated during the recent 15-year period at the Department of Surgery, Seoul National University Hospital and were analysed to evaluate the clinical characteristics and outcome of surgical
treatment
retrospectively.
Thirty four patients comprised of 6 males and 28 females. The age distribution was between 18 and 68 years. The presenting clinical manifestations were associated with arthralgia or bone fracture in 21 (62%), recurrent urinary stone in 17 (50%),
muscle
weakness in 9 (26%), gastrointestinal symptoms in 7 (21%), hypertension in 7 (21%), neurologic symptoms in 4 (12%). There were 4 patients with asymptomatic hypercalcemia. All patients showed hypercalcemia and serum parathyroid hormone level was
elevated
in all 13 patients after the year 1992, in which the quantitative determination of intact parathyroid hormone could be measured. Preoperative localization study was performed with ultrasonography, computerized tomography and thallium-technetium
subtraction scan. Positive localization was made in 64% (16/25), 62% (18/29), respectively. All patients were treated by surgery. Histopathologic findings revealed solitary adenoma in 32 patients and carcinoma in 2 patients. Transient
hypocalcemia
occured in 26 patients and they were supplied with calcium for four months on average. There were no recurrent cases except one who had carcinoma.
In this study, most of the patients were discovered with advanced status clinically and biochemically. They were treated by successfully with parathyroidectomy without major complications.
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