Severe Manifestation of Hyperparathyroidism With Sagliker Syndrome: A Case Report.

Sagliker syndrome represents a rare and severe manifestation of secondary renal osteodystrophy in patients with end-stage chronic kidney disease. We present the case of a 26-year-old woman on peritoneal dialysis with a one-year history of progressive craniofacial deformity involving both the maxilla and mandible. Laboratory tests demonstrated markedly elevated parathyroid hormone levels (1,936 pg/mL). Cranial CT revealed a diffuse "salt and pepper" pattern, serpiginous lytic trabecular changes, and focal ground-glass areas in the calvarium. Correlation of severe hyperparathyroidism with these characteristic imaging features confirmed Sagliker syndrome. Early recognition is essential to prevent irreversible deformities and long-term morbidity. The patient was managed through a multidisciplinary approach, including medical optimization of secondary hyperparathyroidism, followed by total parathyroidectomy due to persistent biochemical abnormalities and progressive craniofacial deformity.