Severe Manifestation of Hyperparathyroidism With Sagliker Syndrome: A Case Report

TL;DR

A 26-year-old woman with kidney disease developed severe facial deformities due to Sagliker syndrome, a rare condition linked to high parathyroid hormone levels.

Contribution

This case highlights the importance of early recognition and multidisciplinary management of Sagliker syndrome.

Findings

The patient had markedly elevated parathyroid hormone levels (1,936 pg/mL) and characteristic cranial imaging features.

A multidisciplinary approach including parathyroidectomy was necessary to manage persistent biochemical abnormalities.

Early diagnosis is critical to prevent irreversible craniofacial deformities and long-term complications.

Abstract

Sagliker syndrome represents a rare and severe manifestation of secondary renal osteodystrophy in patients with end-stage chronic kidney disease. We present the case of a 26-year-old woman on peritoneal dialysis with a one-year history of progressive craniofacial deformity involving both the maxilla and mandible. Laboratory tests demonstrated markedly elevated parathyroid hormone levels (1,936 pg/mL). Cranial CT revealed a diffuse “salt and pepper” pattern, serpiginous lytic trabecular changes, and focal ground-glass areas in the calvarium. Correlation of severe hyperparathyroidism with these characteristic imaging features confirmed Sagliker syndrome. Early recognition is essential to prevent irreversible deformities and long-term morbidity. The patient was managed through a multidisciplinary approach, including medical optimization of secondary hyperparathyroidism, followed by total parathyroidectomy due to persistent biochemical abnormalities and progressive craniofacial deformity.

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