PTH and primary hyperparathyroidism: Following this initial presentation, in February 2022, she underwent further diagnostic work-up by the surgical team that confirmed primary hyperparathyroidism, with serum intact PTH level exceeding 2,500 pg/mL (>265 pmol/L) (reference: 12-88 pg/mL (1.27-9.33 pmol/L)) (Figure 1).