Pseudohypoparathyroidism physical examination: Difference between revisions
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{{CMG}}; {{AE}}{{Mazia}} | {{CMG}}; {{AE}}{{Mazia}} | ||
==Overview== | ==Overview== | ||
Patients with pseudohypoparathyroidism type1a , type 1c and pseudopseudohypoparathyroidism | Patients with pseudohypoparathyroidism type1a, type 1c and pseudopseudohypoparathyroidism present by the second decade of life with characteristic physical features of [[Albright's hereditary osteodystrophy]]. Pseudohypoparathyroidism type 1B isolated resistance to [[parathyroid hormone]] without the associated clinical features of [[Albright's hereditary osteodystrophy|Albright's osteodystrophy]]. Mild [[brachydactyly]] is seen in some cases. [[Chondrodystrophy|Blomstrand's chondrodystrophy]] presents with short limbs due to characteristic growth impairment. Secondary [[hyperplasia]] of the [[parathyroid glands]] occurs as a result of associated [[hypocalcemia]]. | ||
==Physical Examination== | ==Physical Examination== | ||
The physical exam findings of pseudohypoparathyroidism, [[acrodysostosis]], [[Chondrodystrophy|Blomstrand's chondrodystrophy]] are as follows:<ref name="pmid28648505">{{cite journal |vauthors=Mantovani G, Elli FM, Corbetta S |title=Hypothyroidism associated with parathyroid disorders |journal=Best Pract. Res. Clin. Endocrinol. Metab. |volume=31 |issue=2 |pages=161–173 |year=2017 |pmid=28648505 |doi=10.1016/j.beem.2017.04.004 |url=}}</ref><ref name="pmid28804209">{{cite journal |vauthors=Ueyama K, Namba N, Kitaoka T, Yamamoto K, Fujiwara M, Ohata Y, Kubota T, Ozono K |title=Endocrinological and phenotype evaluation in a patient with acrodysostosis |journal=Clin Pediatr Endocrinol |volume=26 |issue=3 |pages=177–182 |year=2017 |pmid=28804209 |pmc=5537214 |doi=10.1297/cpe.26.177 |url=}}</ref> | |||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
* Patients with pseudohypoparathyroidism | * Patients with pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism present by the second decade of life with characteristic physical features of [[Albright's hereditary osteodystrophy]] | ||
* | * No association between pseudohypoparathyroidism type 1b with clinical features of [[Albright's hereditary osteodystrophy|Albright's osteodystrophy]] | ||
* Mild [[brachydactyly]] is seen in some cases | |||
===Skin=== | ===Skin=== | ||
* | *Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism: | ||
**Subcutaneous ossifications | **[[Subcutaneous]] [[Ossification|ossifications]] | ||
**Obesity | **[[Obesity]] | ||
===HEENT=== | ===HEENT=== | ||
*Acrodysostosis: | *[[Acrodysostosis]]: | ||
**Small, flat, upturned nose | **Small, flat, upturned [[nose]] | ||
*Blomstrand's chondrodystrophy: | *[[Chondrodystrophy|Blomstrand's chondrodystrophy]]: | ||
** Protruding eyes showing cataracts | ** Protruding [[eyes]] showing [[cataracts]] | ||
** | ** [[Macroglossia]] | ||
** [[Micrognathia]] | |||
** Micrognathia | ** [[Depressed nasal bridge]] | ||
** Depressed nasal bridge | *Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism: | ||
*[[ | **[[Round face]] | ||
* | **[[Frontal]] bossing | ||
*Frontal bossing | **[[Dental]] [[hypoplasia]] | ||
* | |||
===Lungs=== | ===Lungs=== | ||
*Blomstrand's chondrodystrophy: | *[[Chondrodystrophy|Blomstrand's chondrodystrophy]]: | ||
**Narrow thorax | **Narrow [[thorax]] | ||
===Genitourinary=== | ===Genitourinary=== | ||
*Acrodysostosis: | *Acrodysostosis: | ||
**Hypoplastic genitalia | **[[Hypoplastic]] [[genitalia]] | ||
**[[Cryptorchidism]] | **[[Cryptorchidism]] | ||
===Extremities=== | ===Extremities=== | ||
*Acrodysostosis: | *[[Acrodysostosis]]: | ||
**Short hands | **Short [[hands]] | ||
*Blomstrand's chondrodystrophy: | *[[Chondrodystrophy|Blomstrand's chondrodystrophy]]: | ||
**Short limbs | **[[Short limbs]] | ||
**Dwarfism | **[[Dwarfism]] | ||
** | **Advanced [[bone maturation]] in the [[fetus]] resulting in [[neonatal]] death | ||
* | *Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism: | ||
**Shortening of third, fourth, and fifth [[metacarpals]] and [[metatarsals]] | **Shortening of third, fourth, and fifth [[metacarpals]] and [[metatarsals]] | ||
*Pseudohypoparathyroidism type 1B | |||
**Mild [[brachydactyly]] | |||
===Neuromuscular=== | ===Neuromuscular=== | ||
* | *Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism: | ||
**Mild to moderate intellectual disability | **Mild to moderate [[intellectual disability]] | ||
==References== | ==References== | ||
Latest revision as of 19:58, 20 October 2017
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Pseudohypoparathyroidism Microchapters |
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Differentiating Pseudohypoparathyroidism from other Diseases |
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Pseudohypoparathyroidism physical examination On the Web |
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American Roentgen Ray Society Images of Pseudohypoparathyroidism physical examination |
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Risk calculators and risk factors for Pseudohypoparathyroidism physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]
Overview
Patients with pseudohypoparathyroidism type1a, type 1c and pseudopseudohypoparathyroidism present by the second decade of life with characteristic physical features of Albright's hereditary osteodystrophy. Pseudohypoparathyroidism type 1B isolated resistance to parathyroid hormone without the associated clinical features of Albright's osteodystrophy. Mild brachydactyly is seen in some cases. Blomstrand's chondrodystrophy presents with short limbs due to characteristic growth impairment. Secondary hyperplasia of the parathyroid glands occurs as a result of associated hypocalcemia.
Physical Examination
The physical exam findings of pseudohypoparathyroidism, acrodysostosis, Blomstrand's chondrodystrophy are as follows:[1][2]
Appearance of the Patient
- Patients with pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism present by the second decade of life with characteristic physical features of Albright's hereditary osteodystrophy
- No association between pseudohypoparathyroidism type 1b with clinical features of Albright's osteodystrophy
- Mild brachydactyly is seen in some cases
Skin
- Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism:
HEENT
- Acrodysostosis:
- Small, flat, upturned nose
- Blomstrand's chondrodystrophy:
- Protruding eyes showing cataracts
- Macroglossia
- Micrognathia
- Depressed nasal bridge
- Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism:
- Round face
- Frontal bossing
- Dental hypoplasia
Lungs
- Blomstrand's chondrodystrophy:
- Narrow thorax
Genitourinary
- Acrodysostosis:
Extremities
- Acrodysostosis:
- Short hands
- Blomstrand's chondrodystrophy:
- Short limbs
- Dwarfism
- Advanced bone maturation in the fetus resulting in neonatal death
- Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism:
- Shortening of third, fourth, and fifth metacarpals and metatarsals
- Pseudohypoparathyroidism type 1B
- Mild brachydactyly
Neuromuscular
- Pseudohypoparathyroidism type 1a, type 1c and pseudopseudohypoparathyroidism:
- Mild to moderate intellectual disability
References
- ↑ Mantovani G, Elli FM, Corbetta S (2017). "Hypothyroidism associated with parathyroid disorders". Best Pract. Res. Clin. Endocrinol. Metab. 31 (2): 161–173. doi:10.1016/j.beem.2017.04.004. PMID 28648505.
- ↑ Ueyama K, Namba N, Kitaoka T, Yamamoto K, Fujiwara M, Ohata Y, Kubota T, Ozono K (2017). "Endocrinological and phenotype evaluation in a patient with acrodysostosis". Clin Pediatr Endocrinol. 26 (3): 177–182. doi:10.1297/cpe.26.177. PMC 5537214. PMID 28804209.