Calcium and Phosphorus Metabolism, Parathyroid Hormone, Calcitonin and Bone Histology in Pseudohypoparathyroidism*

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Abstract
High blood levels of immunreactive parathyroid hormone and normal levels of calcitonin were detected in a 14‐yearoIdgirl suffering from pseudohypoparathyroidism. Antibodies to parathyroid hormone have not been detected. Normalization of the serum calcium concentration suppressed parathyroid hormone and stimulated calcitonin secretion to a reproducible extent. Prolonged administration of parathyroid extract induced an increase ofphosphaturia and subsequently normalized the serum calcium level, while intestinal absorption of calcium did not improve. High values for the exchangeable calcium pool and the bone accretion rate of calcium were found. Histologically the iliac crest bone showed a deficient degree of mineralization and a high osteoclastic activity. Treatment with die hydrotachysterol for over a year did not normalize the respons‐of urinary excretion of phosphate and cyclic AMP to administration of parathyroid extract. The data presented are compatible with a relative resistance of the renal tubules, the bone tissue and probably the gut to parathyroid hormone and with the co‐existence of a moderate degree of osteomalacia and secondary hyperparathyroidism.