{'fraction_non_alphanumeric': 0.03474484256243214, 'fraction_numerical': 0.019543973941368076, 'mean_word_length': 5.247457627118644, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Severe hyperparathyroidism associated with fibrous dysplasia: a case report.

Dr. Nurol Arik, Ondokuz Mayis University, School of Medicine, Department of Nephrology, TR-55139 Kurupelit-Samsun (Turkey) Dear Sir, Hyperparathyroidism (HPT) as a main etiologic factor of uremic bone disease may cause serious morbidity in uremic patients. On the other hand, fibrous dysplasia (FD) of bone is a disease of unknown etiology in which fibrous tissue replaces normal bone elements and its association with primary HPT has been rarely reported before [1]. In this report, we present a hemodialysis patient with severe HPT concomitant with craniofascial FD causing abnormal fascial deformity. A 26-year-old woman was admitted to our hospital with a history of progressive difficulty in walking, widespread bone pain and abnormal enlargement of her face. Her history also revealed that she had been on regular hemodialysis therapy for 6 years because of renal failure of unknown etiology. Physical examination showed abnormal bilateral enlargement of the maxilla and mandible as well as multiple nodules palpable in the thy-roidal region (fig. 1). Laboratory studies were as follows; serum calcium 7.6 mg/dl, serum phosphorus 6.3 mg/dl, alkaline phos-phatase 1,560 U/l (normal 98-279), and parathyroid hormone (intact PTH) 1,749 ng/ ml (normal 12-72). Bone roentgenograms disclosed extensive typical signs of HPT including widespread Brown tumor formation. Computerized tomography showed significant enlargement of all parathyroid glands as well as a well-trabeculated tumoral pattern in the maxilla and mandible. A whole-body bone scan was obtained following intravenous injection of 20 mCi 99mTc methylenedi-phosphonate. All scintigraphic features of renal osteostrophy including multiple nodules Fig. 1. Bilateral maxillary and mandibular enlargement.