STUDIES OF HYPOPARATHYROIDISM AND PSEUDOHYPOPARATHYROIDISM

  • 1 January 1978
    • journal article
    • research article
    • Vol. 47  (188) , 533-548
Abstract
Hypocalcemic patients [28] were studied, 14 hypoparathyroid, 9 pseudohypoparathyroid and 2 hypo-hyperparathyroid, to characterize the essential features of these disorders. Tetany was present in 12 patients and epilepsy occurred in 13 patients, 7 of who had received anticonvulsants for 2-8 yr before hypocalcemia was detected. Differentiation between primary and pseudohypoparathyroidism could not be made with certainty on clinical grounds but confident distinction could be made by measurement of endogenous parathyroid hormone [PTH] concentrations and by testing for renal resistance to exogenous PTH. This was achieved by measurement of the plasma and, in some patients, the urinary cyclic AMP response to an i.v. injection of highly purified bovine PTH. These investigations were also valuable in the assessment of the other 3 hypocalcemic patients in whom a diagnosis of parathyroid dysfunction would othewise have been made. In 10 of the patients synthetic 1.alpha.-hydroxylated forms of vitamin D were used to establish and maintain normocalcemia, though their use required careful monitoring.