A patient with diabetic nephropathy developed secondary hyperparathyroidism. Hyperparathyroidism is seen in all of the following conditions, EXCEPT:
High-Yield Explanation
In chronic kidney disease, hyperphosphatemia and decreased renal production of 1,25-dihydroxycholecalciferol (1,252D3) initially produce a decrease in ionized calcium. The parathyroid glands are stimulated (secondary hyperparathyroidism) and may enlarge, becoming autonomous (teiary hyperparathyroidism). In osteomalacia and rickets, hypocalcemia acts as stimulus to secondary hyperparathyroidism. Ref: Shoback D., Sellmeyer D. (2011). Chapter 8. Metabolic Bone Disease. In D.G. Gardner, D. Shoback (Eds), Greenspan's Basic & Clinical Endocrinology, 9e.