Endocrine Abstracts

Peudohypoparathyroidism is a heterogenous group of disorders characterized by hypocalcemia, hyperphosphatemia, increased serum concentration of parathormone, and insensivity to biological activity of parathormone.

A 45-year-old female was admitted to the regional hospital for check up and routine laboratory studies revealed slightly decreased level of calcium. Her neurologic examination was negative for Chvostek’s and Trousseau’ signs. Laboratory testing revealed low calcium (8.1 mg/dL; reference: 9.5–10.5 mg/dL) with elevated PTH (388 pg/mL; reference: 12–72 pg/mL) and phosphate levels. 25 hydroxycholecalciferol (56 ng/mL; reference: 7.6–75 ng/mL), and 1.25 dihydroxycholecalciferol levels were normal (40 pg/mL; reference: 30–60 pg/mL). This laboratory tests indicative of PTH resistance and suggested PHP. We therefore applied Ellswoth- Howard (EH) test, which shows receptor function and the presence of intracellular signal transduction disorder in renal tubular cells and to determine the type of PHP.

Both the phosphaturic (Δ) and urinary c AMP (Uc AMP) responses were estimated. The Δ P responses in the patient was significantly lower than normal response (18 mg/2 h) but its UcAMP response did not differ (Δ c AMP ≥7.9 μmol/h and after/ before c AMP ratio: 13.2) from normal subjects. This was suggested us that the patient had PHP type II. We started treatment with calcium (2000 mg daily) and 1.25- vitamin D3 (0.5 μg daily).

Many individuals affected by pseudohypoparathyroidism type II (PHP-II) have no apparent clinical symptoms and may show only a mild PTH elevation as evidence of PTH resistance. Patients with pseudohypoparathyroidism type II lack the features of Albright’s hereditary osteodystrophy and may manifest hormonal resistance limited to target tissues.

Peudohypoparathyroidism is a heterogenous group of disorders characterized by hypocalcemia, hyperphosphatemia, increased serum concentration of parathormone, and insensivity to biological activity of parathormone.

A 45-year-old female was admitted to the regional hospital for check up and routine laboratory studies revealed slightly decreased level of calcium. Her neurologic examination was negative for Chvostek’s and Trousseau’ signs. Laboratory testing revealed low calcium (8.1 mg/dL; reference: 9.5–10.5 mg/dL) with elevated PTH (388 pg/mL; reference: 12–72 pg/mL) and phosphate levels. 25 hydroxycholecalciferol (56 ng/mL; reference: 7.6–75 ng/mL), and 1.25 dihydroxycholecalciferol levels were normal (40 pg/mL; reference: 30–60 pg/mL). This laboratory tests indicative of PTH resistance and suggested PHP. We therefore applied Ellswoth- Howard (EH) test, which shows receptor function and the presence of intracellular signal transduction disorder in renal tubular cells and to determine the type of PHP.

Both the phosphaturic (Δ) and urinary c AMP (Uc AMP) responses were estimated. The Δ P responses in the patient was significantly lower than normal response (18 mg/2 h) but its UcAMP response did not differ (Δ c AMP ≥7.9 μmol/h and after/ before c AMP ratio: 13.2) from normal subjects. This was suggested us that the patient had PHP type II. We started treatment with calcium (2000 mg daily) and 1.25- vitamin D3 (0.5 μg daily).

Many individuals affected by pseudohypoparathyroidism type II (PHP-II) have no apparent clinical symptoms and may show only a mild PTH elevation as evidence of PTH resistance. Patients with pseudohypoparathyroidism type II lack the features of Albright’s hereditary osteodystrophy and may manifest hormonal resistance limited to target tissues.