# 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.

## Key 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.