The diagnosis of multinodular goiter and primary hyperparathyroidism was established, with serum calcium (sCa) of 11.5 mg/dL (normal range: 8.4–10.2), parathyroid hormone (PTH) of 264 pg/mL (normal range: 10–60), and normal 25- and 1,25-hydroxyvitamin D. She was also diagnosed with autoimmune pernicious anemia with positive anti-intrinsic factor antibodies and anti-parietal cell antibodies, and primary autoimmune hypothyroidism with high titers of anti-thyroperoxidase antibodies (>10,000 IU/mL; normal range: <35). The gene discussed is PTH; the disease is multinodular goiter.