PTH and Pseudohypoparathyroidism

[Kluver_Bucy]

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Why is there an increase in PTH in Pseudohypoparathyroidism. Doesn't that defeat the purpose of calling it hypo? Anyone know the calcium and phosphate levels? Thanks a Bunch guys.

 

[dcpark74]

Why is there an increase in PTH in Pseudohypoparathyroidism. Doesn't that defeat the purpose of calling it hypo? Anyone know the calcium and phosphate levels? Thanks a Bunch guys.

pseudohypoparathyroidism is due to end organ resistance to PTH (e.g. the kidney). Therefore, it's as if there is no PTH in our system (even though there is normal/elevated PTH levels)...hence the term 'pseudo.'

it's part of AHO...and presents with hypocalcemia, hyperphosphatemia, and elevated PTH due to hypocalcemia.

hope this anwers your ?

think also about type II diabetes...insulin resistance, elevated glucose in spite of elevated insulin...('pseudohypoinsulinemia'-not a real term but more for concept)

 

[HiddenTruth]

pseudohypoparathyroidism is due to end organ resistance to PTH (e.g. the kidney). Therefore, it's as if there is no PTH in our system (even though there is normal/elevated PTH levels)...hence the term 'pseudo.'

it's part of AHO...and presents with hypocalcemia, hyperphosphatemia, and elevated PTH due to hypocalcemia.

hope this anwers your ?

think also about type II diabetes...insulin resistance, elevated glucose in spite of elevated insulin...('pseudohypoinsulinemia'-not a real term but more for concept)

Vit D should be elevated owing to the hypocalcemia.

 

[46&2]

Vit D should be elevated owing to the hypocalcemia.

Vit D decreases. Probably because you won't be responding to PTH, hence you won't do the whole 1-alpha-hydroxylase converting stored to active form of VitD in the kidney thing.

From Cecil's:

In pseudohypoparathyroidism, apparent bone and kidney resistance to PTH results in hypocalcemia, retention of phosphate, and low serum 1,25-dihydroxyvitamin D levels ( Chapter 260 )... Undoubtedly, hypocalcemia, secondary hyperparathyroidism, and low serum 1,25-dihydroxyvitamin D levels are important cofactors in the pathogenesis of the disease. Patients respond well to pharmacologic amounts of vitamin D or replacement doses of 1,25-dihydroxyvitamin D.

 

[HiddenTruth]

Vit D decreases. Probably because you won't be responding to PTH, hence you won't do the whole 1-alpha-hydroxylase converting stored to active form of VitD in the kidney thing.

From Cecil's:

In pseudohypoparathyroidism, apparent bone and kidney resistance to PTH results in hypocalcemia, retention of phosphate, and low serum 1,25-dihydroxyvitamin D levels ( Chapter 260 )... Undoubtedly, hypocalcemia, secondary hyperparathyroidism, and low serum 1,25-dihydroxyvitamin D levels are important cofactors in the pathogenesis of the disease. Patients respond well to pharmacologic amounts of vitamin D or replacement doses of 1,25-dihydroxyvitamin D.

hmm, that's kinda tricky since both hypocalcemia and PTH are stimuli for 1 alpha hydroxylase. Good call on that one--how skimpy, BRS even left out vit D levels in psuedo. I guess they were too busy to look it up in cecils.

 

[*fatmike*]

Remember: Count your Knucles at birth!

K-K-D-D = pseudohypoPTH

K-K-D-K = Turners Syndrome

 

[Bounty]

Remember: Count your Knucles at birth!

K-K-D-D = pseudohypoPTH

K-K-D-K = Turners Syndrome

?

 

[Doc Ivy]

?

I think if I remember correctly pseudohypoPTH causes the 4th and 5th metacarpals to shorten-- you can pick it up at birth if you're astute

 

[Kluver_Bucy]

Does anyone know what causes tertiary hyperparathyroidism and what the lab values look like? Thanks in advance.

 

[Cookie Monster]

Isn't it Albright's that has a short 4th metacarpal?? Does turner's also?

 

[HiddenTruth]

Isn't it Albright's that has a short 4th metacarpal?? Does turner's also?

albrights (psuedyohypoPTH) has a short 4th and 5th metacarpal, while turner has a short 4th only.