FURTHER STUDIES ON PSEUDO-HYPOPARATHYROIDISM: REPORT OF FOUR NEW CASES

Abstract

1 man and 3 women, all short of stature, had muscle tenderness, hyperirritable reflexes, negative urinary Sulkowitch tests, depressed serum Ca (4.8-7.7 mg./ 100 ml.) and elevated P (4.3-9.2 mg./100 ml.). Parathormone failed to cause a phosphate diuresis. Ca deposits occurred in basal ganglia and other soft tissues. Parathyroid glands were hyperplastic in 2 cases which were biopsied. 1 case had brachy-dactylia of metacarpals (commonest site, according to literature), and 2 cases were feebleminded. One patient''s serum was tested for precipitins and neutralizing antibodies against parathormone in dogs, and no evidence of antibodies was found. Syndrome consists of 3 parts: end-organ resistance to parathormone; dyschondroplasia manifested by shortening of bones (especially metacarpals); and tendency to subcutaneous calcific deposits. Any combination of these characteristics may occur in a given case.