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It is rare in children but common in adults, particularly in women around the age of 50. In 85% of cases, PHPT is asymptomatic and is diagnosed following hypercalcemia and elevated PTH levels during routine examinations. PHPT occurring before the age of 25 and the normocalcemic phenotype are unusual situations that may delay diagnosis. These nonclassical forms expose patients to severe bone complications that can cause disability. Our objective is to report three clinical cases of PHPT revealed by catastrophic skeletal deformities and pathological fractures.<\/jats:p>","DOI":"10.1155\/crie\/9622659","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T08:19:38Z","timestamp":1768897178000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Three Malagasy Cases of Severe Bone Complications Revealing Primary Hyperparathyroidism"],"prefix":"10.1155","volume":"2026","author":[{"given":"Zolalaina","family":"Andrianadison","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalao Nomenjanahary","family":"Rakotonirina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1851-6518","authenticated-orcid":false,"given":"Oliva Henintsoa","family":"Rakotonirainy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamonjisoa Olivier","family":"Andrianiaina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mbola Narison Lala","family":"Rakotomahefa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahafahantsoa","family":"Rapelanoro Rabenja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-67-6-1294"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031014"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2021.105129"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/89.12.921"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000112592"},{"key":"e_1_2_10_6_2","unstructured":"CunyT. 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