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J Clin Endocrinol Metab ; 104(3): 823-826, 2019 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-30418563

RESUMEN

Context: Type 1A pseudohypoparathyroidism (PHP-1A) is characterized by target organ resistance to PTH. Patients can present with various dysmorphic features; however, renal failure has not been classically described. Case Description: A female patient came to our attention at the age of 7 years with characteristic signs of PTH resistance (i.e., hypocalcemia, hyperphosphatemia, and high serum PTH levels). She also presented with hypothyroidism, early-onset obesity, short metacarpal bones, and multiple subcutaneous ossifications, leading to a clinical diagnosis of pseudohypoparathyroidism. In addition to her genetic condition, she had bilateral renal hypodysplasia that was slowly progressing to end-stage kidney disease. She received a kidney transplant at the age of 16 years and, after transplantation, experienced rapidly normalized calcium, phosphate, and PTH levels, allowing f withdrawal of vitamin D supplementation. Conclusions: To the best of our knowledge, ours is the first report of a patient with PHP-1A undergoing kidney transplantation. Normalization of biochemical parameters after the procedure demonstrated that renal tubular resistance to PTH is sufficient to explain the calcium/phosphate abnormalities observed in PHP-1A.


Asunto(s)
Túbulos Renales/fisiopatología , Hormona Paratiroidea/sangre , Seudohipoparatiroidismo/sangre , Insuficiencia Renal/fisiopatología , Calcio/sangre , Niño , Cromograninas/genética , Femenino , Subunidades alfa de la Proteína de Unión al GTP Gs/genética , Humanos , Trasplante de Riñón , Fosfatos/sangre , Seudohipoparatiroidismo/complicaciones , Seudohipoparatiroidismo/genética , Insuficiencia Renal/sangre , Insuficiencia Renal/etiología , Insuficiencia Renal/cirugía , Vitamina D/sangre
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