[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-460702-105":59,"doc-detail-460702-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","osteitis-fibrosa-cystica-an-unusual-cause-of-left-sided-chest-pain","Osteitis Fibrosa Cystica: An Unusual Cause of Left-Sided Chest Pain","","Case report describing osteitis fibrosa cystica (OFC) as an uncommon cause of persistent left-sided chest pain in a 21-year-old male with end-stage renal disease and secondary hyperparathyroidism. The patient reported eight months of moderate pain localized to the left fifth and sixth ribs; imaging showed well-defined expansile lytic rib lesions and features consistent with metabolic bone disease. Laboratory testing revealed markedly elevated PTH with low-normal calcium and elevated phosphorus. The patient declined surgery and improved with calcium and vitamin D supplementation within four weeks, with symptom resolution and normalized calcium and phosphorus despite persistently high PTH.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/osteitis-fibrosa-cystica-an-unusual-cause-of-left-sided-chest-pain/460702/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/osteitis-fibrosa-cystica-an-unusual-cause-of-left-sided-chest-pain/460702.png","ImageObject",300,407,{"name":92,"@type":93},"Levi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What condition caused the patient’s left-sided chest pain?","Question",{"text":112,"@type":113},"The chest pain was attributed to osteitis fibrosa cystica (OFC) resulting from secondary hyperparathyroidism in a patient with end-stage renal disease.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What key findings supported secondary hyperparathyroidism and OFC?",{"text":117,"@type":113},"Elevated parathyroid hormone with decreased serum calcium and increased phosphorus were documented, and imaging showed expansile lytic rib lesions consistent with metabolic bone disease.",{"name":119,"@type":110,"acceptedAnswer":120},"How was the patient managed and what was the outcome?",{"text":121,"@type":113},"The patient declined surgical intervention and was treated conservatively with calcium and vitamin D supplementation, leading to symptom resolution and normalization of calcium and phosphorus within four weeks.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460702,1790759153,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":52,"preview_page_count":4},7971461740909,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Wiley  \nCase Reports in Nephrology  \nVolume 2026, Article ID 3576066, 4 pages [https://doi.org/10.1155/crin/3576066](https://doi.org/10.1155/crin/3576066)  \nCase Report  \nOsteitis Fibrosa Cystica: An Unusual Cause of Left-Sided Chest Pain  \nRaahima Habib , Maha Anjum , Ayesha Mahmood , and Nabiha Rizvi   \nDepartment of Nephrology, Ghurki Trust and Teaching Hospital, Jallo Mor, Lahore, Pakistan  \nCorrespondence should be addressed to Raahima Habib; [raahimah@gmail.com](raahimah@gmail.com)  \nReceived 5 May 2025; Revised 18 December 2025; Accepted 22 December 2025  \nAcademic Editor: Poulami Jha  \nCopyright © 2026 Raahima Habib et al. Case Reports in Nephrology published by John Wiley & Sons Ltd. Tis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.  \nWe report a case of osteitis fbrosa cystica resulting from secondary hyperparathyroidism in a 21-year-old male patient with endstage renal disease. Te patient presented with persistent, moderate chest pain localized to the left ffth and sixth ribs for eight months. A chest X-ray revealed well-defned, expansile lytic lesions in these ribs. Prior testing showed elevated parathyroid hormone (PTH) levels for fve years, along with decreased serum calcium and elevated phosphorus levels. Findings from ultrasound and SPECT scans were consistent with hyperparathyroidism. Repeat laboratory tests showed a PTH level of 939.8 pg/mL (normal: 10–69 pg/mL), calcium level of 8.3 mg/dL (normal: 8.4–10.2 mg/dL), and phosphorus level of 5.1 mg/dL (normal: 2.5–5.0 mg/dL) . Te patient declined surgical intervention and was managed conservatively with calcium and vitamin Dsupplementation. Within 4 weeks, symptoms resolved and calcium and phosphorus levels normalized, although PTH levels remained elevated. Osteitis fbrosa cystica can be challenging to diagnose due to its rarity, especially in developed countries, and its nonspecifc clinical presentation. Tis case highlights the importance of considering this diagnosis and outlines an approach to management in resource-limited settings.  \n1. Introduction  \nSecondary hyperparathyroidism is a common complication of chronic kidney disease (CKD), occurring in about 40%–80% in patients with Stage 3 and Stage 4 CKD, respectively [1] . As a result of renal dysfunction, serum levels of phosphorus increase, whilst calcium and calcitriol decrease, stimulating the parathyroid glands to secrete high levels of parathyroid hormone (PTH) [2] . A rare manifestation of untreated secondary hyperparathyroidism is osteitis fbrosa cystica (OFC), a non-neoplastic osteolytic metabolic bone disease [3] . Clinically, it may present as fractures, skeletal deformities, and bone pain [4] . To prevent efects on quality of life, it is important to ensure early diagnosis and efective treatment.  \nWe present the case ofa 21-year-old male with end-stage renal disease, presenting with persistent chest pain due to OFC. Tis case report will aid in understanding the disease since its symptoms are nonspecifc and overlap with other  \nconditions such as bone tumors [3] . Furthermore, this case highlights the challenges of management in resourceconstrained settings, where prevalence is higher [5] .  \n2. Case Presentation  \nA 21-year-old male, a known case of end-stage renal disease for the past six years and undergoing hemodialysis three times a week, presented to our renal outpatient department with left-sided chest pain. Given the location of the pain and the patient’s comorbidities, ischemic heart disease was considered a possibility and needed to be ruled out due to its potential severity. However, further history revealed that the chest pain had been ongoing for eight months, was localized to the lateral aspect of the left ffth and sixth ribs, and did not radiate. Te pain had a gradual onset, was moderate in intensity, and had persisted since its on","cbCaiiKBBUv5Bygt","https://ap.wps.com/l/cbCaiiKBBUv5Bygt","pdf",1001963,"English","# Introduction\n# Case Presentation","[{\"question\":\"What condition caused the patient’s left-sided chest pain?\",\"answer\":\"The chest pain was attributed to osteitis fibrosa cystica (OFC) resulting from secondary hyperparathyroidism in a patient with end-stage renal disease.\"},{\"question\":\"What key findings supported secondary hyperparathyroidism and OFC?\",\"answer\":\"Elevated parathyroid hormone with decreased serum calcium and increased phosphorus were documented, and imaging showed expansile lytic rib lesions consistent with metabolic bone disease.\"},{\"question\":\"How was the patient managed and what was the outcome?\",\"answer\":\"The patient declined surgical intervention and was treated conservatively with calcium and vitamin D supplementation, leading to symptom resolution and normalization of calcium and phosphorus within four weeks.\"}]","Osteitis Fibrosa Cystica: An Unusual Cause of Left-Sided Chest Pain | PDF"]