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Clinical Problem Solving: Pathology
April 2002

Diagnosis Pathology Quiz Case 2

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2002;128(4):455. doi:

Since the advent of dialysis, patients with chronic renal failure have lived longer and have developed sequelae of renal failure, including secondary hyperparathyroidism. Patients with renal failure have hyperphosphatemia, with high levels of phosphate-binding calcium, causing a relative state of hypocalcemia. Also, the intestines absorb less calcium because there is inadequate renal conversion of vitamin D to its active form. The parathyroid glands respond by increasing their output of parathyroid hormone in order to increase the calcium level, thereby causing increased osteoclastic activity and bone resorption, a condition known as osteitis fibrosa cystica, and ultimately culminating in the development of a brown tumor.1

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