ABSTRACT
A case is reported of intermittent hypercalcaemia, hypophosphataemia and severe skeletal rarefaction with cystic changes. An occult calcium malabsorption was found. Fat, triolein and iron absorption and radiological examinations were normal. There was gross intestinal mucosal atrophy. She was shown to be in a state of negative calcium balance and this was reversed by vitamin D. A gluten-free diet also improved calcium absorption. It is postulated that the patient had severe secondary hyperparathyroidism as the skeleton reverted to normal after six months of medical treatment.
