Coexisting Paget's disease of bone and hyperparathyroidism.

A patient with Paget's disease of bone and primary hyperparathyroidism is described. It has been suggested that a metabolite from pagetic tissue might stimulate parathyroid cell function. To test this, serum parathyroid hormone (iPTH) levels were measured by radio immunometric assay in 106 patients with Paget's disease of bone and 139 control subjects. There was no significant difference between the mean levels of the two groups. Of five sera with elevated PTH levels QUOSO extraction revealed an interfering substance in 3/5 from control patients tested and extractable iPTH in 2/2 from Paget's patients. One of the latter had renal failure. The results suggest that increased parathyroid function is unlikely to be a primary event in the genesis of Paget's disease of bone.