A 14-year-old girl presents with progressive muscle cramps and perioral paresthesias. Vital signs: BP 118/76, HR 88, RR 16, Temp 37°C, SpO2 98%. Physical examination reveals short stature, central obesity, and shortened fourth and fifth metacarpals bilaterally. Laboratory studies show serum calcium 7.2 mg/dL, phosphate 5.8 mg/dL, and PTH 156 pg/mL. Thyroid function tests are normal. Which of the following is the most likely diagnosis?
- A)Primary hyperparathyroidism
- B)Familial hypocalciuric hypercalcemia
- C)Hypoparathyroidism
- D)PseudohypoparathyroidismGABARITO
- E)Vitamin D deficiency
Explicação
Pseudohypoparathyroidism is end organ resistance to PTH, often associated with Albright hereditary osteodystrophy. Because the kidney and bone do not respond appropriately, calcium is low and phosphate is high despite elevated PTH. The shortened metacarpals ar... Ver explicação completa e trilha adaptativa →