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1,2Clinical Specialists, Department of Internal Medicine, Hospital Tuanku Fauziah, Perlis, Malaysia A 40-year old man with end-stage renal failure secondary to diabetic nephropathy had been on regular haemodialysis for the past seven years. He was poorly compliant with a low phosphate diet and had developed tertiary hyperparathyroidism. On August 2018 his intact parathyroid hormone was 1320pg/ml (normal range 10–65pg/ml) and ultrasonography of his neck revealed multiple enlarged parathyroid glands. He was subsequently referred for parathyroidectomy.

The Silver Lining: Pleural Calcification in An End-Stage Renal Disease Patient with Tertiary Hyperparathyroidism