COMBINED PRIMARY AND SECONDARY HYPERPARATHYROIDISM: TWO CASE REPORTS AND A REVIEW*

doi:10.1059/0003-4819-52-1-87

COMBINED PRIMARY AND SECONDARY HYPERPARATHYROIDISM: TWO CASE REPORTS AND A REVIEW*

EMANUEL GOLDBERG, M.D.
Brooklyn, N. Y.
; and
RICHARD M. TORACK, M.D.
Bronx, N. Y.

Requests for reprints should be addressed to Emanuel Goldberg, M.D., Department of Medicine, State University of New York, Downstate Medical Center,
450 Clarkson Avenue, Brooklyn 3, N. Y.

Excerpt

Although the literature on hyperparathyroidism is extensive, there are few case reports of functioning parathyroid adenoma occurring simultaneously with secondary hyperplasia of the parathyroid gland.^{2, 3, 4, 5, 6} Albright and Reifenstein discussed only one such case when they wrote their classic monograph¹ on metabolic bone disease. Most of the reported cases have not been carefully studied ante mortem, and this is true of the two reported below. Secondary hyperplasia following the removal of a functioning adenoma where there has been irreversible damage to the kidneys has often been reported^{27, 50, 57, 77, 78, 79} and is not hard to

This 100-word excerpt has been provided in the absence of an abstract.

Acknowledgment

We wish to thank Dr. Harry M. Zimmerman, Chief of Laboratories, Montefiore Hospital, Bronx, N. Y., for his constructive comments on this paper.

Summario in Interlingua

Le scrutinio de un collection decenne de studios necroptic a un grande hospital voluntari discoperiva duo casos clarmente characterisate per le presentia de tanto un adenoma cellular principal como etiam de un hyperplasia secundari del glandula parathyroide. Le patiente in un del casos esseva un femina de racia blanc de 59 annos de etate con hypertensive morbo cardiovascular e pyelonephritis chronic qui moriva in uremia con generalisate dismineralisation ossee e alterationes cystic del cranio. Ben que illa habeva uremia con acidosis e elevate nivellos seral de phosphoro, su contento seral de calcium esseva uniformemente normal o elevate (10 a 11 mg%). Le patiente in le secunde caso esseva un masculo de racia blanc de 58 annos de etate, admittite al hospital con confusion mental, disquietude, mal de capite occipital, e debilitate del gamba sinistre. Determinationes del nivellos seral de calcium e phosphoro non esseva effectuate, sed radiogrammas del cranio e del spina lumbar revelava dismineralisation ossee. Le patiente deveniva stuporose e postea comatose, e ille moriva post sex septimanas. Le constatationes pathologic esseva un adenoma parathyroide del typo de cellula principal, secundari hyperplasia parathyroide, e nephrocalcinosis diffuse. Esseva trovate nulle indicio de primari morbo renal.

Cinque casos additional de ille genere esseva trovate in le litteratura. Es presentate un revista del characteristicas clinic e pathologic de iste casos. Illos forma duo gruppos. In le prime il ha disfallimento renal secundari a nephrocalcinosis; in le secunde, morbo renal primari. In ambes, le presentia simultanee de adenoma de cellula principal e de hyperplasia parathyroide secundari esseva associate con nivellos normal o elevate del calcium in le sero.