Brachymetatarsia; How Important Can It Be in Adolescence?
Hypocalcaemia is a dangerous electrolyte imbalance with 18% prevalence in hospital admitted patients. 1 Regulation of calcium level is by 3 main calcium-regulating hormones. These hormones are parathyroid hormone (PTH), vitamin D, and calcitonin; and they act by effecting on the bowel, kidneys, and skeleton. Causes of hypocalcaemia includes vitamin D deficiency, hypoparathyroidism, renal diseases, hypomagnesaemia, hungry bone disease after parathyroidectomy, drugs like calcium chelators, massive blood transfusion, critical illness, parathyroid hormone resistance, vitamin D resistance. Pseudohypoparathyroidism (PHP) refers to a group of metabolic disorders in which resistance to parathyroid hormone leads to hypocalcaemia, hyperphosphatemia, and elevation of serum PTH level in the setting of normal renal function. Herein we report an interesting case of hypocalcaemia who came to the emergency department with suspicion to intracranial hemorrhage and lead to the diagnosis of pseudohypoparathyroidism.
- Cooper, M. S. and N. J. Gittoes (2008). "Diagnosis and management of hypocalcaemia." BMJ: British Medical Journal 336(7656): 1298.
- Fong, J. and A. Khan (2012). "Hypocalcemia." Canadian Family Physician 58(2): 158-162.
- Hoorn, E. J. and R. Zietse (2013). "Disorders of calcium and magnesium balance: a physiology-based approach." Pediatric Nephrology 28(8): 1195-1206.
- Weinstein, L. S. (1998). Albright hereditary osteodystrophy, pseudohypoparathyroidism, and Gs deficiency. G proteins, receptors, and disease, Springer: 23-56.
- Chen, H., et al. (2005). "Multiple intracranial calcifications and spinal compressions: rare complications of type la pseudohypoparathyroidism." Journal of endocrinological investigation 28(9): 646-650.
- Juan, D. (1979). "Hypocalcemia: Differential diagnosis and mechanisms." Archives of Internal Medicine 139(10): 1166-1171.
- Guise, T. A. and G. R. Mundy (1995). "Clinical review 69: Evaluation of hypocalcemia in children and adults." The Journal of Clinical Endocrinology & Metabolism 80(5): 1473-1478.
- Shoback, D. (2008). "Hypoparathyroidism." New England Journal of Medicine 359(4): 391-403.
- Feldman, E. C. (2014). Hypocalcemia and primary hypoparathyroidism. Canine and Feline Endocrinology: Fourth Edition, Elsevier Inc.
- Bilezikian, J. P., et al. (2011). "Hypoparathyroidism in the adult: Epidemiology, diagnosis, pathophysiology, target‐organ involvement, treatment, and challenges for future research." Journal of Bone and Mineral Research 26(10): 2317-2337.
- Schimizzi, A. and M. Brage (2004). "Brachymetatarsia." Foot and ankle clinics 9(3): 555-570.
- Mantovani, G. (2011). "Pseudohypoparathyroidism: diagnosis and treatment." The Journal of Clinical Endocrinology & Metabolism 96(10): 3020-3030.
- Underbjerg, L., et al. (2016). "Pseudohypoparathyroidism–epidemiology, mortality and risk of complications." Clinical endocrinology 84(6): 904-911.