Abstract
In Reply.— In our discussion of a 76-year-old patient with chondrocalcinosis and hyperparathyroidism, we mentioned that the patient did not undergo neck exploration. The statement does not represent our recommendation for the management of elderly patients with primary hyperparathyroidism. We realize that surgical resection is the treatment of choice for patients with hyperparathyroidism. However, this patient was an elderly man with several chronic medical problems that made him a poor surgical candidate. He was completely asymptomatic with respect to his hypercalcemia, had no roentgenographic evidence of hyperparathyroidism, and had normal renal function. In addition, he was a cooperative patient who reported consistently for follow-up examinations. Therefore, he did not fit most of the criteria for surgical treatment recommended by Scholz and Purnell 1 in their ten-year prospective study on asymptomatic primary hyperparathyroidism. After thorough evaluation by our endocrinology consultants, it was decided to follow up this patient medically.
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