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Vitamin D Abnormalities in Hypoparathyroidism and Pseudohypoparathyroidism

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Vitamin D

Abstract

Hypoparathyroidism (HP) is caused by absence or hypoplasia of the parathyroid glands. The disorder may be either idiopathic or acquired. The idiopathic form is usually sporadic and occasionally familial. Sex-linked (1), recessive (2), and dominant forms (3) of transmission are described. Absence or hypoplasia of the parathyroids occur in patients with disorders of development of the pharyngeal pouches, the DiGeorge Syndrome. This usually involves abnormalities of the third and fourth pouches (4), but may involve defects in any of the six pouches so that the term branchial dysembryogenesis (5) was suggested. There are associated aplasia and/or hypoplasia of the thymus and a high incidence of anomalies of the aortic arch and congenital heart disease, the most common of which are a right aortic arch, tetralogy of Fallot and patent ductus arteriosus (4,5). Patients also exhibit facies which are characterized by mild hypertelorism, slight anti-mongoloid slanting of the eyes, asymmetric low-set malformed ears, a fish mouth and an anomaly of the palate (4).

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References

  1. Peden VH: True idiopathic hypoparathyroidism as a sex-linked trait. Am. J. Hum. Genet. 12: 323–337, 1960.

    PubMed  CAS  Google Scholar 

  2. Bronsky D, Kiamko RT, Waldstein SS: Familial idiopathic hypoparathyroidism. J. Clin. Endocrinol. Metab. 28: 61–65, 1968.

    Article  PubMed  CAS  Google Scholar 

  3. Barr DGD, Prader A, Esper U, Rampini S, Marrian VJ, Forfar JO: Chronic hypoparathyroidism in two generations. Helv. Paediatr. Acta 26: 507–521, 1971.

    PubMed  CAS  Google Scholar 

  4. Freedom RM, Rosen FS, Nadas AS: Congenital cardiovascular disease and anomalies of the third and fourth pharyngeal pouch. Circulation 46: 165–172, 1972.

    PubMed  CAS  Google Scholar 

  5. Miller MJ, Frame B, Poznaski AK, Jackson CE, Bermudez G: Branchial anomalies in idiopathic hypoparathyroidism: branchial dysombryo-genesis. Henry Ford Hosp. Med. Bull. 20: 3–14, 1972.

    Google Scholar 

  6. Spinner MW, Blizzard RM, Childs B: Clinical and genetic heterogeneity in idiopathic Addison’s disease and hypoparathyroidism. J. Clin. Endocrinol. Metab. 28: 795–804, 1968.

    Article  PubMed  CAS  Google Scholar 

  7. Blizzard RM, Chee D, Davis W: The incidence of parathyroid and other antibodies in the sera of patients with hypoparathyroidism. Clin. Exp. Immunol. 1: 119–128, 1966.

    PubMed  CAS  Google Scholar 

  8. Kirkpatrick CH, Rich ER, Bennett JE: Chronic mucocutaneous candidiasis. Model building in cellular immunity. Ann. Intern. Med. 74: 955–978, 1971.

    PubMed  CAS  Google Scholar 

  9. Michie W, Stowers JM, Duncan T, Pegg CAS, Hamer-Hodges DW, Hems G, Bewsher PD, Hedley AJ: Mechanism of hypocalcemia after thyroidectomy for thyrotoxicosis. Lancet 1: 508–514, 1971.

    Article  PubMed  CAS  Google Scholar 

  10. Wade JSH, Goodall P, Deane L, Dauncey TM, Fourman P: The course of partial parathyroid insufficiency after thyroidectomy. Br. J. Surg. 52: 497–514, 1965.

    Article  PubMed  CAS  Google Scholar 

  11. Orme MCLE, ConnoleyM: Hypoparathyroidism after iodine-131 treatment of thyrotoxicosis. Ann. Int. Med. 75: 136–137, 1971.

    PubMed  CAS  Google Scholar 

  12. Horwitz CA, Meyers WPL, Foote FW: Secondary malignant tumors of the parathyroid glands. Report of two cases with associated hypoparathyroidism. Am. J. Med. 52: 797–808, 1972.

    Article  PubMed  CAS  Google Scholar 

  13. Dimich A, Bedrossian PB, Wallach S: Hypoparathyroidism: clinical observations in 34 patients. Arch. Int. Med. 120: 449–458, 1967.

    Article  CAS  Google Scholar 

  14. Lund Bj, Sorenson OH, Lund Bi, Bishop JE, Norman AW: Vitamin D metabolism in hypoparathyroidism. J. Clin. Endocrinol. Metab. 51: 606–610, 1980.

    Article  PubMed  CAS  Google Scholar 

  15. Nordin BEC, Peacock M: Role of kidney in regulation of plasma calcium. Lancet II: 1280–1283, 1969.

    Google Scholar 

  16. Russell RGG, Walton RJ, Smith R, Preston C, Basson R, Henderson RG, Norman AW: 1,25-Dihydroxycholecalciferol and 1α-hydroxycholecalciferol in hypoparathyroidism. Lancet 11: 14–17, 1974.

    Article  Google Scholar 

  17. Neer RM, Holick MF, DeLuca HF, Potts JT Jr: Effects of 1α-hydroxy-vitamin D3 on calcium and phosphorus metabolism in hypoparathyroidism. Metabolism 24: 1403–1413, 1975.

    Article  PubMed  CAS  Google Scholar 

  18. Eisenberg E: Effects of serum calcium level and parathyroid extract on phosphate and calcium excretion in hypoparathyroid patients. J. Clin. Invest. 44: 942–946, 1965.

    Article  PubMed  CAS  Google Scholar 

  19. Bell NH, Avery S, Sinha T, Clark CM Jr, Allen DO, Johnston C Jr: Effects of dibutyryl cyclic adenosine 3′,5′-monophosphate and parathyroid extract on calcium and phosphorus metabolism in hypoparathyroidism and pseudohypoparathyroidism. J. Clin. Invest. 51: 816–823, 1972.

    Article  PubMed  CAS  Google Scholar 

  20. Kugelberg E: Neurologic mechanism for certain phenomena in tetany. Arch. Neurol. Psychiatry 52: 507–521, 1946.

    Google Scholar 

  21. Williams GT, Brown M: Laryngospasm in hypoparathyroidism. J. Laryngol. Otol. 88: 369–373, 1974.

    PubMed  CAS  Google Scholar 

  22. Wijnbladh H: Postoperative tetany. A study based on 40 treated cases. Acta Endocrinol. 10: 1–16, 1952.

    PubMed  CAS  Google Scholar 

  23. Edmondson JW, Brashear RF, Li TK: Tetany: qualtitative interrelationships between calcium and alkalosis. Am. J. Physiol. 228: 1082–1086, 1975.

    PubMed  CAS  Google Scholar 

  24. Hoffman E: The Chvostek Sign. A clinical study. Am. J. Surg. 96: 33–37, 1958.

    Article  PubMed  CAS  Google Scholar 

  25. Lewis T: Trousseau’s phenomenon in tetany. Clin. Sci. 4: 361–364, 1942.

    Google Scholar 

  26. Frame B: Neuromuscular manifestations of parathyroid disease. In: Handbook of Clinical Neurology, Vinken PB, Bruyn GW (eds), vol 27, Amsterdam, North Holland, 1976, p 283–320.

    Google Scholar 

  27. Basser LS, Neale FC, Ireland AW, Posen S: Epilepsy and electro-encephalographic abnormalities in chronic surgical hypoparathyroidism. Ann. Intern. Med. 71: 507–515, 1969.

    PubMed  CAS  Google Scholar 

  28. Swash M, Rowan AJ: Electroencephalographic criteria for hypocalcemia and hypercalcemia. Arch. Neurol. 26: 218–228, 1972.

    PubMed  CAS  Google Scholar 

  29. Palmer RF, Searles HH, Boldrey EB: Papilledema and hypoparathyroidism simulating brain tumor. J. Neurosurg. 16: 378–384, 1959.

    Article  PubMed  CAS  Google Scholar 

  30. Dent CE, Garretts M: Skin changes in hypocalcemia. Lancet I: 142 - 146, 1960.

    Article  Google Scholar 

  31. Risum G: Psoriasis exacerbated by hypoparathyroidism with hypocalcemia. Br. J. Derm. 89: 309–312, 1973.

    Article  CAS  Google Scholar 

  32. Hinrichs EH: Dental changes in idiopathic juvenile hypoparathyroidism. Oral Surg. 9: 1102–1114, 1956.

    Article  PubMed  Google Scholar 

  33. Ireland AW, Hornbrook JW, Neale FC, Posen S: The crystalline lens in chronic surgical hypoparathyroidism. Arch. Int. Med. 122: 408–411, 1968.

    Article  CAS  Google Scholar 

  34. Yu PNG: The electrocardiographic changes associated with hypercalcemia and hypocalcemia. Am. J. Med. Sci. 224: 413–423, 1952.

    Article  PubMed  CAS  Google Scholar 

  35. Clarkson B, Kowlessar OD, Horwith M, Sleisenger M: Clinical and metabolic study of a patient with malabsorption and hypoparathyroidism. Metabolism 9: 1093–1106, 1960.

    PubMed  CAS  Google Scholar 

  36. Bronsky D, Kushner DS, Dubin A, Snapper I: Idiopathic hypoparathyroidism and pseudohypoparathyroidism: case reports and review of the literature. Medicine 37: 317–352, 1958.

    Article  PubMed  CAS  Google Scholar 

  37. Steinberg H, Waldron BR: Idiopathic hypoparathyroidism: Analysis of 52 cases, including report of new case. Medicine 31: 133–154, 1952.

    Article  PubMed  CAS  Google Scholar 

  38. Bell NH: Dynamics of bone metabolism. Ann. Rev. Med. 18: 299–312, 1967.

    Article  PubMed  CAS  Google Scholar 

  39. Drezner MK, Neelon FA, Jowsey J, Lebovitz HE: Hypoparathyroidism: a possible cause of osteomalacia. J. Clin. Endocrinol. Metab. 45: 114–122, 1977.

    Article  PubMed  CAS  Google Scholar 

  40. Bell NH, Epstein S, Stern PH, Hypercalcemia during long-term treatment with 1,25-dihydroxyvitamin D3 in hypoparathyroidism. N. Engl. J. Med. 301: 1183–1184, 1979.

    Article  PubMed  CAS  Google Scholar 

  41. Albright F, Burnett CH, Smith PH, Parson W: Pseudohypoparathyroidism - an example of the Sebright-Bantam syndrome. Endocrinology 30: 922–932, 1942.

    CAS  Google Scholar 

  42. Elrick H, Albright F, Bartter FC, Forbes AP, Reeves JD: Further studies on pseudohypoparathyroidism: report of four new eases. Acta Endocrinol. 5: 199–225, 1950.

    PubMed  CAS  Google Scholar 

  43. Chase LR, Melson GL, Aurbach GD: Pseudohypoparathyroidism: defective excretion of 3′,5′-AMP in response to parathyroid hormone. J. Clin. Invest. 48: 1832–1844, 1969.

    Article  PubMed  CAS  Google Scholar 

  44. Bell NH, Avery S, Sinha T, Clark CM Jr, Allen DO, Johnston CC Jr: Effects of dibutyryl cyclic adenosine 3′,5′-monophosphate and parathyroid extract on calcium and phosphorus metabolism in hypoparathyroidism and pseudohypoparathyroidism. J. Clin. Invest. 51: 816–823, 1972.

    Article  PubMed  CAS  Google Scholar 

  45. Bell NH, Khairi MRA, Johnston CC Jr, Stern PH, DeLuca HF, Hamstra A, Meunier P, Edouard C, Alexandre C: Effects of 1,25-dihydroxyvitamin D3 on calcium metabolism and quantitative bone histology in pseudo-hypoparathyroidism. In: Endocrinology of Calcium Metabolism, Proceedings of the Sixth Parathyroid Conference. Amsterdam, Excerpta Medica, 1977, p 33–38.

    Google Scholar 

  46. Lawoyin S, Norman DA, Zerwekh J, Breslau N, Pak CYC: A patient with pseudohypoparathyroidism with increased serum calcium and 1α,25- dihydroxyvitamin D after exogenous parathyroid hormone administration. J. Clin. Endocrinol. Metab. 49: 783–786, 1979.

    Article  PubMed  CAS  Google Scholar 

  47. Kidd GS, Schaaf M, Adler RA, Lassman MN, Wray HL: Skeletal responsiveness of pseudohypoparathyroidism: a spectrum of clinical disease. Am. J. Med. 68: 772–781, 1980.

    Article  PubMed  CAS  Google Scholar 

  48. Lambert PW, Hollis BW, Bell NH, Epstein S: Demonstration of a lack of change in serum 1α, 25-dihydroxyvitamin D in response to parathyroid extract in pseudohypoparathyroidism. J. Clin. Invest. 66: 782–791, 1980.

    Article  PubMed  CAS  Google Scholar 

  49. Rodriquez H, Villarreal H Jr, Klahrs S, Slatopolsky E: Pseudohypo-parathyroidism type II: restoration of normal renal responsiveness to parathyroid hormone by calcium administration. J. Clin. Endocrinol. Metab. 39: 693–701, 1974.

    Article  Google Scholar 

  50. Werder EA, Fischer JA, Illig R, Kind HP, Bernasconi S, Fanconi A, Prader A: Pseudohypoparathyroidism and idiopathic hypoparathyroidism: relationship between serum calcium and parathyroid hormone levels and urinary cyclic adenosine-3′,5′-monophosphate response to parathyroid extract. J. Clin. Endocrinol. Metab. 46: 872–879, 1978.

    Article  PubMed  CAS  Google Scholar 

  51. Drezner MK, Burch WM Jr: Altered activity of the nucleotide regulatory site on the parathyroid hormone-sensitive adenylate cyclase from the renal cortex of a patient with pseudohypoparathyroidism. J. Clin. Invest. 62: 1222–1227, 1978.

    Article  PubMed  CAS  Google Scholar 

  52. Farfel ZF, Brickman AS, Kaslow HR, Brothers VM, Bourne HR: Defect of receptor-cyclase coupling protein in pseudohypoparathyroidism. N. Engl. J. Med. 303: 237–242, 1980.

    Article  PubMed  CAS  Google Scholar 

  53. Levine MA, Downs RW Jr, Singer M, Marx SJ, Aurbach GD, Spiegel AM: Deficient activity of guanine nucleotide regulatory protein in erythrocytes from patients with pseudohypoparathyroidism. Biochem. Biophys. Res. Comm. 94: 1319–1324, 1980.

    Article  PubMed  CAS  Google Scholar 

  54. Marx SJ, Hershman JM, Aurbach GD: Thyroid dysfunction in pseudohypoparathyroidism. J. Clin. Endocrinol. Metab. 33: 822–828, 1971.

    Article  PubMed  CAS  Google Scholar 

  55. Werder EA, Illig R, Bernasconi S, Kind H, Prader A: Excessive thyrotropin response to thyrotropin-releasing hormone in pseudohypoparathyroidism. Pediatr. Res. 9: 12–16, 1975.

    CAS  Google Scholar 

  56. Carlson HE, Brickman AS, Bottazzo GF: Prolactin deficiency in pseudohypoparathyroidism. N. Engl. J. Med. 296: 140–144, 1977.

    Article  PubMed  CAS  Google Scholar 

  57. Kruse K, Gutekunst B, Kracht U, Schwerda K: Deficient prolactin response to parathyroid hormone in hypocalcemic and normocalcemic pseudohypoparathyroidism. J. Clin. Endocrinol. Metab. 52: 1099–1105, 1981.

    Article  PubMed  CAS  Google Scholar 

  58. Brickman AS, Weitzaan RE: Renal resistance to arginine vasopressin in pseudohypoparathyroidism. Clin. Res. 26: 164A, 1978.

    Google Scholar 

  59. Wolfsdorf JI, Rosenfeld RL, Fang VS, Kobayashi R, Razdan AK, Kim MH: Partial gonadotrophin-resistance in pseudohypoparathyroidism. Acta Endocrinol. 88: 321–328, 1978.

    PubMed  CAS  Google Scholar 

  60. Nagant de Deuxchaisnes C, Fischer JA, Dambacher MA, Devogelaer J-P, Arber CE, Zanelli JM, Parsons JA, Loveridge N, Bitensky L, Chayen J: Dissociation of parathyroid hormone bioactivity and immune-reactivity in pseudohypoparathyroidism type I. J. Clin. Endocrinol. Metab. 53: 1105–1109, 1981.

    Google Scholar 

  61. Yamaoki K, Seino Y, Ishida M, Ishii T, Shimotsuji T, Tanaka Y, Kurose H, Matsuda S, Satomura K, Yabuuchi H: Effect of dibutyryl adenosine 3′,5′-monophosphate administration on plasma concentrations of 1,25-dihydroxyvitamin D in pseudohypoparathyroidism type I. J. Clin. Endocrinol. Metab. 53: 1096–1100, 1981.

    Article  Google Scholar 

  62. Au WYW, Raisz LG: Restoration of parathyroid responsiveness in vitamin D-deficient rats by parenteral calcium or dietary lactose. J. Clin. Invest. 46: 1572–1578, 1967.

    Article  PubMed  CAS  Google Scholar 

  63. Kakuta S, Suda T, Sasaki S, Kimura N, Nagata N: Effects of parathyroid hormone on the accumulation of cyclic AMP in bone of vitamin D-deficient rats. Endocrinology 97: 1288–1293, 1975.

    Article  PubMed  CAS  Google Scholar 

  64. Massry SG, Tuma S, Dua S, Goldstein DA: Reversal of skeletal resistance to parathyroid hormone in uremia by vitamin D metabolites. J. Lab. Clin. Med. 94: 152–157, 1979.

    PubMed  CAS  Google Scholar 

  65. Woodhouse NJY, Doyle FH, Jophin GF: Vitamin D deficiency and primary hyperparathyroidism. Lancet II: 283–287, 1971.

    Google Scholar 

  66. Metz SA, Baylink DJ, Hughes MR, Haussler MR, Robertson RP: Selective deficiency of 1,25-dihydroxycholecalciferol: a cause of isolated skeletal resistance to parathyroid hormone. N. Engl. J. Med. 297: 1084–1090, 1977.

    Article  PubMed  CAS  Google Scholar 

  67. Heersche JNM, Heyboer MPM, Ny B: Hormone-specific suppression of adenosine 3′,5′-monophosphate responses in bone in vitro during prolonged incubation with parathyroid hormone, prostaglandin E, and calcitonin. Endocrinology 103: 333–340, 1978.

    Article  PubMed  CAS  Google Scholar 

  68. Wong GL: Induction of metabolic change and down regulation of bovine parathyroid hormone-responsive adenylate cyclase are dissociable in isolated osteoclastic and osteoblastic bone cells. J. Biol. Chem. 254: 34–37, 1979.

    PubMed  CAS  Google Scholar 

  69. Raisz LG, Neimann I: Effect of phosphate, calcium, and magnesium on bone resorption and hormonal responses in tissue culture. Endocrinology 85: 446–452, 1969.

    Article  PubMed  CAS  Google Scholar 

  70. Bell NH, Gerard ES, Bartter FC: Pseudohypoparathyroidism with osteitis fibrosa cystica and impaired absorption of calcium. J. Clin. Endocrinol. Metab. 23: 759–772, 1963.

    Article  PubMed  CAS  Google Scholar 

  71. Potts JT Jr: Pseudohypoparathyroidism. In: The Metabolic Basis of Inherited Disease, Stanbury JB, Wyngaarden JB, Frederickson DS (eds), New York, McGraw-Hill Book Co., 1978, p 1350–1365.

    Google Scholar 

  72. Moses AM, Breslau N, Coulson R: Renal responses to PTH in patients with hormone-resistant (pseudo) hypoparathyroidism. Am. J. Med. 61: 184–189, 1976.

    Article  PubMed  CAS  Google Scholar 

  73. George FW, Wilson JD: Pathogenesis of the henny feathering trait in the Sebright Bantam chicken: increased conversion of androgen to estrogen in skin. J. Clin. Invest. 66: 57–65, 1980.

    Article  PubMed  CAS  Google Scholar 

  74. Levin IG, Papapoulos SE, O’Riordan JLH: 1α-hydroxyvitamin D3 in the long-term management of hypoparathyroidism and pseudohypopara-thyroidism. Clin. Endocrinol. (Suppl) 7: 203s–207s, 1977.

    Google Scholar 

  75. Bell NH, Stern PH: Hypercalcemia and increases in serum hormone during prolonged administration of 1α,25-dihydroxyvitamin D. N. Engl. J. Med. 298: 1241–1243, 1978.

    Article  PubMed  CAS  Google Scholar 

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© 1984 Martinus Nijhoff Publishing, Boston/The Hague/Dordrecht/Lancaster

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Bell, N.H. (1984). Vitamin D Abnormalities in Hypoparathyroidism and Pseudohypoparathyroidism. In: Kumar, R. (eds) Vitamin D. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2839-1_25

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  • DOI: https://doi.org/10.1007/978-1-4613-2839-1_25

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