Pitfalls in the Diagnosis of Primary Hyperparathyroidism in a Sudanese Adolescent Boy; a case disguised as rickets

Table 1 Biochemical workup of the patient on presentation, pre-and postoperatively

Parameter (normal references)	Baseline	At our unit	1 day Pre OP^*	5 days Post OP⁺	21 days Post OP⁺	Last visit
	6/12/2019	25/2/2020	15/10/2020	20/10/2020	5/11/2020	7/6/2021
Serum Ca⁺² (8.1–10.4 mg/dl)	11.7	14	10.7	7.8	6.6	8.7
Serum Po⁺² (3.5–5.5 mg/dl)		2.7				5.1
ALP (48–162 IU/L)		5556				352
25-hydroxyvitamin D (> 30 ng/dl)	8.1	12
Creatinine		0.3
GFR (mL/min/1.73m²)		120
PTH^† (15–65 pg/ml)		3509				45
Urine Ca/Cr^†† ratio (< 0.20 mg:mg)		0.65

^*Preoperative,⁺ Postoperative, ^† Parathyroid Hormone, ^†† Calcium to Creatinine

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