{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:34:26Z","timestamp":1785321266467,"version":"3.55.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Primary hyperparathyroidism due to overproduction of parathyroid hormone may present with fatigue, renal stone, abdominal pain, constipation; However, it is rare to observe a pathological fracture as the initial manifestation. We present a case of a young woman with multiple fractures, highlighting the diagnostic challenge. Case presentation: A 35-year-old woman was presented with pain, swelling, and restricted movement in her right upper limb and unable to stand after a minor fall. Initially, she received treatment in the orthopedics department for fractured right humerus and both shaft of femur, then transferred to the medicine department for further evaluation. Serum parathyroid and calcium levels were elevated. A 99m TC MIBI parathyroid SPECT\u2013CT scan revealed persistence of the intense focal radiotracer concentration at right lobe thereby confirming a lower right parathyroid adenoma. Conclusions: This case underscores the potential for primary hyperparathyroidism to manifest with atypical symptoms, leading to delayed diagnosis and management.<\/jats:p>","DOI":"10.1093\/omcr\/omaf180","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T13:53:44Z","timestamp":1760450024000},"source":"Crossref","is-referenced-by-count":1,"title":["Multiple fractures in primary hyperparathyroidism: a challenging case report"],"prefix":"10.1093","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8840-1193","authenticated-orcid":false,"given":"Dilruba Sharmen","family":"Nishu","sequence":"first","affiliation":[{"name":"Department of Medicine, Dhaka medical college and hospital , Secretariat Road, Dhaka-1000 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazi Jannatul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mugda medical college and hospital , Hazi Kadam Ali Road, Dhaka-1214 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md","family":"Nazim-Al-Azad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mugda medical college and hospital , Hazi Kadam Ali Road, Dhaka-1214 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Anamul","family":"Haque","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mugda medical college and hospital , Hazi Kadam Ali Road, Dhaka-1214 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Sayedur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mugda medical college and hospital , Hazi Kadam Ali Road, Dhaka-1214 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nusrat","family":"Karim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mugda medical college and hospital , Hazi Kadam Ali Road, Dhaka-1214 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9924-0060","authenticated-orcid":false,"given":"Monira","family":"Sarmin","sequence":"additional","affiliation":[{"name":"icddr,b Dhaka Hospital, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali-1212, International Centre for Diarrhoeal Diseases Research, (icddr,b) ,","place":["Bangldesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Monjurul","family":"Haque","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mugda medical college and hospital , Hazi Kadam Ali Road, Dhaka-1214 ,","place":["Bangladesh"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"2025102907303074500_ref1","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"2025102907303074500_ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000491034","article-title":"Primary hyperparathyroidism","volume":"51","author":"Masi","year":"2019","journal-title":"J Parathyr Dis"},{"key":"2025102907303074500_ref3","doi-asserted-by":"publisher","first-page":"521578","DOI":"10.1155\/2011\/521578","article-title":"An unusual presentation of primary hyperparathyroidism: pathological fracture","volume":"2011","author":"Khaoula","year":"2011","journal-title":"Case Rep Orthop"},{"key":"2025102907303074500_ref4","doi-asserted-by":"publisher","DOI":"10.3329\/bjnm.v22i2.51765","article-title":"Primary hyperparathyroidism with multiple fractures and Brown Tumors in a 14-year-old girl: Case Report & Review of literature","volume":"22","author":"Khan","year":"2019","journal-title":"Bangladesh J"},{"key":"2025102907303074500_ref5","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1186\/s12891-021-04326-1","article-title":"Osteitis Fibrosa Cystica and pathological fractures\u2014the classic but neglected skeletal manifestation of primary hyperparathyroidism: a case report","volume":"22","author":"Vanitcharoenkul","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"2025102907303074500_ref6","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/s0020-1383(01)00134-6","article-title":"Pathological fractures in primary hyperparathyroidism. A case report highlighting diagnostic difficulties","volume":"33","author":"Morgan","year":"2002","journal-title":"Injury"},{"key":"2025102907303074500_ref7","first-page":"706","article-title":"Pathological fracture femur In primary hyperparathyroidism-uncommon complications and orthopaedic challenges: a case report","volume":"6","author":"Kolachala","year":"2023","journal-title":"Int J"},{"key":"2025102907303074500_ref8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12902-020-00669-3","article-title":"Symptomatic primary hyperparathyroidism in a young woman presenting with multiple skeletal destructions: a case report and review of literature","volume":"21","author":"Lu","year":"2021","journal-title":"BMC Endocr Disord"},{"key":"2025102907303074500_ref9","doi-asserted-by":"publisher","first-page":"108158","DOI":"10.1016\/j.ijscr.2023.108158","article-title":"Pathological subtrochanteric fracture revealing a primary hyperparathyroidism: a case report","volume":"106","author":"Haouzi","year":"2023","journal-title":"Int J Surg Case Rep"},{"key":"2025102907303074500_ref10","doi-asserted-by":"publisher","first-page":"146","DOI":"10.13107\/jocr.2025.v15.i07.5802","article-title":"A primary hyperparathyroidism in an adolescent female with pathological fractures and multiple bone lesions due to parathyroid adenoma: case report","volume":"15","author":"Singh","year":"2025","journal-title":"J Orthop Case Rep"},{"key":"2025102907303074500_ref11","doi-asserted-by":"publisher","first-page":"3083","DOI":"10.21873\/anticanres.15092","article-title":"Pathological fracture of the tibia as a first sign of hyperparathyroidism\u2013a case report and systematic review of the current literature","volume":"41","author":"Keiler","year":"2021","journal-title":"Anticancer Res"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2025\/10\/omaf180\/65022958\/omaf180.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2025\/10\/omaf180\/65022958\/omaf180.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T11:30:42Z","timestamp":1761737442000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omaf180\/8305642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":11,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,21]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omaf180","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,10]]},"article-number":"omaf180"}}