Gastrointestinal Manifestations of Hyperparathyroidism

INTEREST in the association between endocrine tumors and gastrointestinal lesions has been quite active in the last decade, stimulated mainly by the delineation of the Zollinger-Ellison syndrome.1However, other endocrine-gastrointestinal relationships have been studied as well, in particular, gastrointestinal symptoms with hyperparathyroidism.2Furthermore, a high incidence of peptic ulcer has been found to be associated with the syndrome of multiple endocrine adenomatosis3(adenomas affecting the anterior pituitary, parathyroid, pancreas, adrenal, or thyroid glands). However, the exact mechanism of symptoms, the incidence and the significance of the coexisting lesions, and the relationship between the endocrine tumor and the gastrointestinal lesion remain obscure. Because of the relative rarity of these syndromes and the importance of early diagnosis, we are presenting three case reports of hyperparathyroidism that initially were associated with gastrointestinal symptoms. Report of Cases Case 1. —A 44-year-old woman was first examined at the Cleveland Clinic in September 1963, because of