Collum, Justin, Jones, Robert H.B., Lynham, Anthony, and Hirst, Julian (2013) Leontiasis ossea: a presentation of hyperparathyroidism in an Indigenous Australian man secondary to chronic renal failure. Journal of Oral and Maxillofacial Surgery, 71 (1). pp. 56-61.

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Abstract

[Extract] Leontiasis ossea is a term that can be used to describe the progressive hypertrophy of facial and cranial bones associated with a group of diseases, including Paget disease and fibrous dysplasia, 1 and in patients with chronic renal failure and secondary hyperparathyroidism. It is important that the clinician is aware of the diagnosis and management of this debilitating condition. Although rare, the consequences of poor management and treatment can be serious. Furthermore, patients who are diagnosed with this condition require intensive management by a multidisciplinary team.

Chronic renal failure is the progressive and irreversible loss of renal function that can result in end-stage renal disease requiring dialysis or transplantation for survival. 2 Chronic renal failure results in hyperphosphatemia and hypocalcemia, which increases the production of the parathyroid hormone (PTH), with subsequent hypercalcemia. This results in increased bone formation and resorption. 2 The effects of this process result in a range of musculoskeletal manifestations referred to as renal osteodystrophy. At the extreme of this range is a complication of chronic renal failure known as uremic leontiasis ossea. 1 and 3

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