Erosive spondylo-arthropathy and tertiary hyperparathyroidism

A patient on long term haemodialysis for analgesic nephropathy, with known teriary hyperparathyroidism developed a rapidly evolving, erosive, non-infective spondylo-arthropathy at two vertebral levels. In addition, erosions were noted adjacent to the right sacroiliac joint. Subsequent postmortem material from the affected vertebral levels demonstrated changes consistent with hyperparathyroidism alone and this is suggested as the possible aetiology underlying this recently recognised destructive spondyloarthropathy.