OBSERVATIONS ON HYPOPARATHYROIDISM. II. INACTIVATION OF PARATHYROID HORMONE IN A CASE OF CLINICAL HYPOPARATHYROIDISM

Abstract

IN THE preceding article (1) we have described a case of generalized exfoliative dermatitis associated with hypoparathyroidism. This paper is concerned with biochemical investigations on the same patient. It is customary to distinguish two forms of clinical hypoparathyroidism—true idiopathic hypoparathyroidism and pseudohypoparathyroidism. The latter condition has been described by Albright et al. (2). Clinically it is indistinguishable from true idiopathic or postoperative hypoparathyroidism. In the pseudo form, however, the defect seems to originate not in the parathyroid gland itself but in the target cells (e.g., kidney, bones), which are refractory to the parathyroid hormone (3). The defect appears to be congenital and leads to disturbances in development predominantly affecting the skeleton. The patients are short. Their metacarpal and metatarsal bones are also short, but in an irregular manner, so that often there are marked differences in length of fingers and toes. The patients usually have a round face, a short neck, calcifications in the basal ganglia, cataracts, strabismus, and other congenital malformations.