Treatment of hyperparathyroidism.

To the Editor.— In their discussion of chondrocalcinosis associated with hyperparathyroidism, Drs Aronchick and Dalinka1conclude that since the patient was 76 years old and had other medical problems, it was elected to treat him symptomatically; hence, no neck exploration was performed. It is unwarranted to cite age as a contraindication to parathyroid surgery. Although persons with hypercalcemia and minimal symptoms have been reported to survive comfortably as long as three decades without surgical treatment,2the literature supports parathyroidectomy in elderly hyperparathyroid patients in all but the most dire circumstances. At our institution in the last year alone, four uncomplicated parathyroidectomies on patients aged 65 years or older have been performed with subsequent normocalcemia in each patient. Two recently published series3,4report a total of 29 patients aged 70 years or older undergoing parathyroidectomy without complication. No age-specific risk factors were identified. These authors state that the