Primary Hyperparathyroidism Associated with Pancytosis

To the Editor: In 1949 Berlin¹ first described an association between primary hyperparathyroidism and polycythemia in a patient with duodenal and esophageal ulcers who did not survive long enough for a determination of whether treatment of the parathyroid disease might have resulted in remission of the polycythemia. In 1981 Godeau et al.² described a case in which there was remission of hypercalcemia and pancytosis after resection of a parathyroid adenoma. For 18 years we have followed a woman who was first seen at age 15 because of nausea, anorexia, and weight loss and was found to have pancytosis (hemoglobin, 20.