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Tertiary hyperparathyroidism is characterized by increased parathyroid hormone (PTH) secretion that appears after prolonged secondary hyperparathyroidism, leading to the onset of hypercalcemia. The parathyroid glands are found to undergo hyperplastic or adenomatous changes and act autonomously with increased parathormone secretion not suppressed by feedback control. This entity is commonly associated with long-term secondary hyperparathyroidism states, such as chronic kidney disease, renal transplantation, and gastrointestinal malabsorption. The authors describe the case of a 50-year-old female with a history of biliopancreatic diversion surgery, renal lithiasis with recurrent obstructive pyelonephritis, and a work accident with significant limitation of mobility. She was referred to hospital consultation for a pathological fracture of the dorsal vertebra in the context of tertiary hyperparathyroidism due to long-term gastrointestinal malabsorption.
Fernandes et al. (Wed,) studied this question.