A Rare Case of Sagliker Syndrome in 16 Year-old Child: Complication of Untreated Hyperparathyroidism

Sagliker syndrome is a syndrome described in patients with chronic kidney disease (CKD) in the course of untreated or inadequately treated secondary hyperparathyroidism. We reported one patient male, 16 year-old with CKD stage V on regular hemodialysis, presented with change in facial feature overtime, characterized by uglifying face with enlarged upper and lower jaws, malformation of jaws, oral mass, abnormality of teeth, and deformity of legs. That manifestation was accompanied by history of bone fracture and other problems such as cardiomyopathy, mild tricuspid regurgitation, trivial mitral regurgitation. Laboratory examination found hyperparathyroid, vitamin D insufficiency, hypocalcemia, hyperphosphatemia, anemia, thrombocytopenia, and decreased glomerular filtration rate. Radiological imaging found osteodystrophy appearance on long bones, calvaria, and jaw bones. Patient had history of inadequately treated mineral disorder. Patient was treated by regular hemodialysis, antihypertensive medication, calcitriol, phosphate binder, folic acid, and erythropoeitin stimulating agent after recognition of the syndrome. Parathyroidectomy cannot be done in this patient. The early recognition of Sagliker syndrome would lead to safe and effective treatment by parathyroidectomy and medication which can decrease morbidity and longterm complication. The inability to correct all the morphologic changes can be catastrophic for those patients, hence appropriate treatment for CKD must begin early by the time of diagnosis in specialized centers.