The state of health of patients previously operated on for primary hyperparathyroidism compared with randomized controls.

240 patients operated on for PHPT in the years 1956-79 were compared with 240 sex and age matched randomized controls to examine the present state of health of the patients. Diseases which occurred in both groups were registered to clarify their possible association with PHPT. Recurring urinary tract infections occurred as often in both groups, though renal stones had naturally been more frequent in the PHPT group. Serum creatinine was elevated in 33 PHPT patients and in 9 controls (p less than 0.001), and renal damage was also more severe in the PHPT patients. Malaise and fatigue occurred in 29 PHPT patients and in 14 controls (p less than 0.05). Medically treated hypertension was found in 95 PHPT patients and in 53 controls (p less than 0.001). Eight PHPT patients and one control had had pancreatitis (p less than 0.01). Peptic ulcer disease and gallstones were registered as frequently in both groups. 16 PHPT patients and three controls had received previous irradiation to the neck region (p less than 0.01). Six PHPT patients, but none of the controls, had had a differentiated non-medullary thyroid carcinoma. Two of the thyroid carcinoma patients had received irradiation. Other malignant diseases were as frequent in both groups. Three controls were hypercalcaemic and had PHPT verified at operation. The prevalence of PHPT in the control group was 1.25%. The state of health was normal in 52% of the PHPT patients and in 68% of the controls (p less than 0.001). The results indicate that PHPT permanently deteriorates the health of the patients and should therefore be diagnosed and treated as early as possible in the course of the disease.