PSEUDO-PSEUDOHYPOPARATHYROIDISM WITH UNUSUAL FEATURES

Abstract

A case of pseudo-pseudohypoparathyroidism with some unusual features is presented. The patient, a 64-year-old diabetic female, was short, somewhat obese, and had a shortened metacarpal of the right ring-finger. The only subcutaneous calcification or ossification was a hitherto undescribed finding in this disorder, namely, ossification of the pinna of each ear. Plasma calcium and phosphorus concentrations were normal. Injection of parathyroid extract of proven potency (Ellsworth-Howard test) did not produce phosphate diuresis, but did increase plasma calcium concentration. Intravenous calcium infusion caused the expected increase in urine and plasma calcium content, but was not followed by the expected normal decrease in urinary phosphate excretion. These findings suggested that there might be a defect in the control of tubular reabsorption of phosphate by parathyroid hormone in this patient, whereas the action of the hormone on calcium metabolism was normal.