A 48-year-old postmenopausal woman with bone and joint pain was misdiagnosed as having normocalcemic primary hyperparathyroidism but was later found to have osteoporosis and secondary hyperparathyroidism caused by prolonged exposure to tenofovir disoproxil fumarate.
The levels of calcium and phosphorus excreted in urine over a 24-hour period were within the normal range but towards the lower end. For the past 9 years, she has been undergoing extended medical care to manage her condition of chronic hepatitis B caused by a viral infection.
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