• Clinical and Experimental Pediatrics
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• v.46 no.10
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• pp.1032-1035
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• 2003

In pseudohypoparathyroidism as reported by Albright in 1942, the parathyroid gland can normally synthesize and secrete parathyroid hormone(PTH). Pseudohypoparathyroidism has a similar biochemical finding with hypoparathyroidisms like hypocalcemia and hyperphosphatemia due to target tissue resistance to PTH. Administered PTH does not raise the serum levels of calcium and urinary phosphate. PTH activates G-protein in peripheral tissue and adenylate cyclase through a second messenger, cAMP. Pseudohypoparathyroidism produces hyperphosphatemia and hypocalcemia because of the resistance to PTH in peripheral tissue due to a defect of G-protein, although it releases PTH normally. According to the mechanism of resistance, pseudohypoparathyroidism is classified into types : Ia, Ib, Ic and psedopseudohypoparathyroism. Type Ia is accompanied by congenital growth retardation and abnormal bony development that shows mental retardation, obesity, low height, round face, short metacarpal bone and metatarsal bone, ectopic calcification, etc. We report a case of pseudohypoparathyroidism in a premature who shows hypocalcemia, hyperphosphatemia, elevation of serum PTH and 24 hr urinary basal c-AMP in biochemical tests without Albright's hereditary osteodystrophy at physical examination, accompanied by a spontaneous fracture in the femur.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.420-421
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• 2018

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2006.11a
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• pp.97-97
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• 2006

• Clinical and Experimental Pediatrics
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• v.53 no.7
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• pp.741-744
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• 2010

Purpose: To evaluate the long-term safety of polyethylene glycol (PEG) 4000 in children with constipation, particularly the biochemical aspects of safety. Methods: Medical records were evaluated, and 100 children, who had been taking PEG 4000 for more than 6 months, and who had been under clinical and biochemical monitoring, were enrolled. Ages; $6.11{\pm}3.12$ years, Duration of therapy; $16.93{\pm}7.02$ months, dose of PEG 4000; $0.72{\pm}0.21g/kg/d$. Results: None of the children complained of clinical adverse effect. The first biochemical test was performed at 8.05 months after beginning of PEG 4000. Serum phosphate (SP) value was high in 10 children, and leucopenia was noted in one child. The second test was performed in 44 children at 7.57 months after the first test. The SP value was high in four children, including the three children whose initial SP value was high and one new child. Six out of 10 children with high initial SP value became normal and one was lost. Hypernatremia was noted in one child. The third test was done in 15 children at 7.5 months after the second test. The SP value of the new child from the second test was high, but became normal after finishing treatment. Two out of 3 children with high SP value at the second test became normal and one was lost. The fourth test was done in 2 children few months after the third test. All of the results were normal. There were no relation between duration of therapy and hyperphosphatemia, or between dose of PEG 4000 and hyperphosphatemia. Conclusions: PEG 4000 is safe for long-term therapy in children with constipation with respect to biochemical parameters.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.603-605
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• 2009

A 7-year-old intact female, Miniature Schnauzer dog was presented with an acute seizure episode and tremors. Fever and panting were noted when presented. Physical examination revealed apparent forelimb muscle rigidity, fasciculations and stiff gait. Characteristic laboratory findings in this dog were severe hypocalcemia with hyperphosphatemia. The low serum concentration of intact parathyroid hormone and ionized calcium levels were consistent with the diagnosis of primary hypoparathyroidism. In addition, there were increased urinary excretion of calcium and decreased urinary excretion of phosphorus in this case. Urgent treatment was initiated with 10% calcium gluconate. The dog remained healthy with vitamin D analogue and oral calcium supplementation. A transient hyperphosphatemia was controlled well with sevelamer hydrochloride. To the author's knowledge, this is the first case report describing the clinical and laboratory characteristic features of canine primary hypoparathyroidism and its clinical outcome in Korea.

• Laboratory Medicine Online
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• v.7 no.2
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• pp.83-87
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• 2017

Pseudohypoparathyroidism (PHP) is a rare disorder caused by genetic and epigenetic aberrations in the GNAS complex locus resulting in impaired expression of stimulatory G protein ($Gs{\alpha}$). PHP type Ib (PHP-Ib) is characterized by hypocalcemia and hyperphosphatemia due to renal resistance to the parathyroid hormone, and is distinguished from PHP-Ia by the absence of osteodystrophic features. An 11-yr-old boy presented with poor oral intake and cramping lower limb pain after physical activity. Laboratory studies revealed hypocalcemia, hyperphosphatemia, and increased parathyroid hormone levels. The GNAS complex locus was evaluated using the methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) assay. Gain of methylation in the NESP55 domain and loss of methylation in the antisense (AS) transcript, XL, and A/B domains in the maternal allele were observed. Consequently, we present a case of PHP-Ib diagnosed using MS-MLPA.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.220-226
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• 1997

Idiopathic hypoparathyroidism is frequently associated with intracranial calcification and neuropsychiatric abnormalities. The most commonly recognized central nervous system manifestations of chronic hypoparathyroidism are seizure, alteration of mental function and extrapyramidal signs. We present a case of hypoparathyroidism, demonstrating extensive intracranial calcification, not only basal ganglia, but also outside the extrapyramidal system. An 58-year-old woman presented with 30 year history of seizure and memory disturbance. The physical examination and several laboratory studies disclosed normal. However hypocalcemia, hyperphosphatemia with hypocalciuria and decreased parathormone level were demonstrated. Clinical symptoms and signs showed improvement after supplementary calcium and Vit $D_3$ therapy.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3555-3560
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• 2012

The tumour lysis syndrome (TLS) is a group of metabolic abnormalities caused by rapid and unexpected release of cellular components into the circulation as a result of massive destruction of rapidly proliferating malignant cells. It usually develops in patients with hematologic malignancies like acute lymphoid leukemia, non-Hodgkin and Burkitt's lymphoma after initiation of chemotherapy or may, rarely, occur spontaneously. Though TLS is seldom observed in relation to solid tumours, there have been reports of connections with examples such as lung, liver, breast, gastric carcinomas. The clinical manifestations of TLS include hyperuricemia, hyperkalemia, hyperphosphatemia and hypocalcemia. These indications if untreated lead to life-threatening complications such as acute renal failure, cardiac arrhythmias, seizures, and eventually death due to multiorgan failure. Therefore early detection of TLS is of vital importance. This can be accomplished by identification of high risk patients, implementation of suitable prophylactic measures andmonitoring of the electrolyte levels in patients undergoing chemotherapy.

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2009.10a
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• pp.217-217
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• 2009

• Journal of Nutrition and Health
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• v.47 no.1
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• pp.33-44
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• 2014

Purpose: Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium. Methods: This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items. Results: The mean body mass index (BMI) was $22.2{\pm}3.0kg/m^2$, mean serum phosphorus level was $4.50{\pm}1.52mg/dl$, and mean serum potassium level was $4.74{\pm}0.73mEq/l$. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (> 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p < 0.05). Mean duration of HD was $7.9{\pm}7.3$ years and it showed positive correlation with serum potassium levels (p < 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p < 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p < 0.01), potatoes, fish, and high-potassium vegetables (p < 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p < 0.05). Conclusion: The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.