The homozygous R25CPTH mutation was identified in patients who presented with hypocalcemia and hyperphosphatemia, despite elevated PTH levels (Lee et al., 2015; Andersen et al., 2022), and the mutation was found to impact the bioactive region of PTH (Lee et al., 2015; Arnold et al., 1990; Parkinson and Thakker, 1992; Sunthornthepvarakul et al., 1999; Ertl et al., 2012). Here, PTH is linked to hyperphosphatemia.