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Updated: Aug 6 2019


  • Introduction
    • Causes of ↓ PTH release include
      • accidental surgical excision (thyroidectomy)
      • autoimmune destruction of parathyroid glands
      • DiGeorge syndrome
        • congenital absence of parathyroid glands
      • hypomagnesemia
        • ↓ functional adenylate cyclase leading to ↓ PTH activity
    • Can also be caused by resistance of PTH
      • pseudohypoparathyroidism
        • renal tubules do not respond in presence of PTH
          • aka Albright hereditary osteodystrophy
        • AD inheritance
  • Presentation
    • Symptoms
      • tetany (hypocalcemia)
    • Physical exam
      • Chvostek's sign
        • contraction of facial muscles when tapped rapidly
      • Trousseau's sign
        • carpal spasm following occlusion of brachial artery with BP cuff
      • findings unique to pseudohypoparathyroidism (Albright hereditary osteodystrophy)
        • shortened 4th/5th digits
          • Turners syndrome only involves 5th digit
        • short stature
  • Evaluation
    • Serology
      • hypocalcemia
      • hyperphosphatemia
  • Treatment
    • Medical
      • calcium + calcitriol (D3) supplemenation
      • teriparatide
        • recombinant PTH
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