RESPIRATORY MUSCLE WEAKNESS IN PRIMARY HYPERPARATHYROIDISM

To the Editor: Gentric and Pennec reported that the death of an old woman was attributable to respiratory failure attributable to primary hyperparathyroidism (PHP).1 To prove the causal relationship they refer to the well known muscular weakness in PHP. However, they write that, to their knowledge, there are no descriptions of the involvement of respiratory muscle in PHP in the literature. Actually, there is one, lending some additional credibility to their assumption of causality. Kristoffersson et al.2 measured maximal expiratory (EP) and inspiratory (IP) pressures in 10 patients before and 6 to 12 months after surgical cure of PHP. EP was improved significantly whereas it did not change in the six controls after neck surgery for benign thyroid disease. IP did not change. Weakness of respiratory muscles still adds to the plethora of clinical problems obviously caused by or associated with PHP. Like most other signs and symptoms of PHP, it is nonspecific. Like them, it may be erroneously considered a “senile” irreversible condition unless the underlying potentially curable hypercalcaemia is revealed by calcaemic screening of geriatric patients.