Pseudohypoparathyroidism

Patients with pseudohypoparathyroidism (PHP) require monitoring to ensure normalization of calcium and phosphate levels.[1]Mantovani G, Bastepe M, Monk D, et al. Diagnosis and management of pseudohypoparathyroidism and related disorders: first international Consensus Statement. Nat Rev Endocrinol. 2018 Aug;14(8):476-500. https://www.nature.com/articles/s41574-018-0042-0 http://www.ncbi.nlm.nih.gov/pubmed/29959430?tool=bestpractice.com Calcium, phosphate, and 25-hydroxyvitamin D levels must be monitored regularly to avoid inadequate or excessive treatment. Calcium and phosphate metabolism changes during acute illness, growth spurts, and pregnancy, and the frequency of monitoring must be increased if any of these are present. The frequency of monitoring also depends on how quickly calcium and phosphorus goals are attained and the frequency of treatment failure. Albright hereditary osteodystrophy is associated with type Ia and Ic PHP, which are the forms most likely to be associated with hypothyroidism. If patients have Albright hereditary osteodystrophy and/or confirmed hypothyroidism, yearly evaluation of thyroid-stimulating hormone is required. In patients with fractures suspicious of osteopenia, bone-density scanning should be obtained. Patients with hypogonadism will also require regular monitoring of sex hormone levels. Regular ophthalmologic exams should be performed to detect cataract formation.