Primary hyperparathyroidism due to (chief-cell hyperplasia- (a review with a case illustration)

• Main Author: Verma H
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 1977-01-01
• Series: Journal of Postgraduate Medicine
• Online Access: http://www.jpgmonline.com/article.asp?issn=0022-3859;year=1977;volume=23;issue=4;spage=197;epage=200;aulast=Verma

A 37 year old man presented with multiple pathological frac-tures, mental symptoms and features o f renal insufficiency without renal stones and nephrocalcinosis. This was found to be a case of primary hyperparathyroidism due to chief cell hyperplasia. Three parathyroids were removed leaving behind the right superior gland. The patient had temporary symptomatic improvement with the healing of the fractures of metacarpals. There was no union of fractures of necks of femora. The symptoms reappeared and the patient died of renal failure more than a year after operation. Severe renal impairment is therefore the most important single complication in advanced osseous lesions. Even if parathyroidectomy is done in such advanced cases probably no permanent clinical improvement may be expected. Better results in these cases might be observed by early diagnosis of the disease and adequate surgery. It is hence suggested that in a case of parathyroid hyperplasia one should aim at excision o f 31- parathyroid glands, i.e., near total parathyroidectomy, to avoid recurrence of disease.