The clinical manifestations of 1° HPT have evolved during the past 4 decades. Today, fewer than 20% of patients suffer from the classic symptoms of 1° HPT initially described in the 1920s to 1940s. Many patients today suffer from vague, nonspecific, but nonetheless real manifestations of the disease. It appears from the data achieved with patient-based outcome instruments that very few patients suffering from jo jjpj trujy asymptomatic. More important, many of these nonclassic symptoms improve after parathyroidectomy. It, therefore, becomes important for the primary care clinician not only to assess the physiologic parameters of 1° HPT but also to be aware of the expanding definition of symptoms associated with this disease. With the broadened guidelines for parathyroidectomy, it appears that the majority of patients with 1° HPT require parathyroidectomy and, more important, benefit from such intervention.


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