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A 40-year-old man presented with a 5-year history of progressive facial changes and difficulty chewing. He had a history of chronic kidney disease and became dialysis dependent at the age of 17. On examination, protruding upper jaw with malocclusion was observed. His intact parathyroid hormone level exceeded 2500 pg/mL (reference range: 15.6–68.3). CT of the face showed cranial bone thickening, …
Contributors T-JL drafted the manuscript. C-WH contributed to patient care and discussion.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.