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Mineral Exchanges of Man

VI. The Effect of Extirpation of a Parathyroid Tumor on the Balances of Electrolytes

Four Figures

Department of Medicine, University of Rochester School of Medicine and Dentistry and Medical Clinic of Strong Memorial Hospital, Rochester, New York

Evidence has been presented which indicates that the extirpation of a parathyroid tumor is accompanied by a temporary derangement of the metabolism of salt and water. It was found that:

1. In addition to the well-recognized alteration in the concentrations of calcium and inorganic phosphorus in the serum and their retention in the body, there was also retention of significant amounts of sodium, potassium, magnesium and chlorine.

2. The retention of the latter group of elements since accompanied by a definite increase in weight strongly suggests an increase in the volume of body water as part of the mechanism involved in readjustment.

3. The temporary nature of the disturbance of salt and water balance was attested by the fact that approximate equilibrium between intake and outgo of sodium and potassium occurred on the fifth or sixth post-operative day and hence coincided with the time at which the concentrations of calcium and inorganic phosphorus of the blood and their excretion in the urine were definitely established at normal levels.

4. While retention of the principal solutes of body fluids was found to follow removal of a parathyroid tumor, an approximately quantitative measurement of the exchanges of sodium, potassium and chlorine did not support the view that alterations in the metabolism of these elements is of primary importance in hyperparathyroidism.

Manuscript received 6 August 1934.