The changing picture of primary hyperparathyroidism in the years 1956-1979.

The aim of this study was to examine the development of the clinical appearance of primary hyperparathyroidism in a material of 334 patients operated on for PHPT in the years 1956-79. The material was divided into three parts: 72 patients from the years 1956-70, 102 patients from the years 1971-75 and 160 patients from the years 1976-79. A marked change was observed in the structure of the material: the mean age of both men and women increased, and the group of women over 50 years became dominating. Symptoms such as renal stones, cystic bone changes and hypercalcaemic crisis proportionally decreased, and nonspecific symptoms as malaise, fatigue and various pains increased. The number of asymptomatic patients also steadily increased. The preoperative serum calcium values were lower in the consecutive groups. The number of small adenomas increased but, on the other hand, the number of big adenomas remained the same. The ratio between single adenomas and multiglandular disease remained unchanged in the three periods. In our material, the general development of the clinical appearance of PHPT seems to have taken only one decade. In the latest period PHPT has been diagnosed considerably more often than before, and the disease has usually been treated at an earlier stage. However, the severe forms of the disease have been diagnosed as frequently in all of the periods.