Unusual presentation of primary hyperparathyroidism with osteoporosis, hypercalcemia, and normal parathyroid hormone level

We report the case of a woman with osteoporosis, chronic hypercalcemia, and normal levels of parathyroid hormone (PTH). Surgical exploration revealed hyperplasia of the parathyroid glands. Hypercalcemia was corrected immediately by surgery, and this was followed by a dramatic improvement in bone mineral density. This case represents a rarely reported presentation of primary hyperparathyroidism with an atypical laboratory finding.