{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T03:49:16Z","timestamp":1648698556701},"reference-count":7,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Endocrinology"],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:p>An 18-year-old negroid woman presented with progressive cramps in both hands. She was Jamaican and had moved to The Netherlands 8 months before. On physical examination Trousseau\u2019s sign was positive. Laboratory analysis showed severe hypocalcaemia (1.17\u2009mmol\/L) and hyperphosphatemia (2.0 mmol\/L). Urinary excretion of both calcium (0.8\u2009mmol\/day) and phosphate (5\u2009mmol\/day) was low, as is seen in hypoparathyroidism. However, the PTH level was increased (22.1\u2009pmol\/L), whereas 25-(OH)-vitamin D was low (31\u2009nmol\/L). An Ellsworth-Howard test showed only a fivefold increase in urinary phosphate excretion after administration of synthetic PTH, supporting the diagnosis pseudohypoparathyroidism. Upon treatment with calcium supplementation and alfacalcidol, her symptoms disappeared. Pseudohypoparathyroidism (PHP) is a rare hereditary disorder resembling hypoparathyroidism, although plasma PTH levels are elevated. PHP is caused by alterations in the PTH receptor, inducing target tissue resistance to PTH. This results in hypocalcaemia and hyperphosphatemia, while PTH levels are elevated. The diagnosis is confirmed by the Ellsworth-Howard test, which will show a 100-fold increase in phosphate excretion if the PTH receptor functions properly. Treatment is lifelong supplementation of calcium and alfacalcidol. In our patient, symptoms were probably evoked by the lack of sunlight in Dutch winter, decreasing vitamin D levels and thereby aggravating hypocalcaemia.<\/jats:p>","DOI":"10.1155\/2012\/739375","type":"journal-article","created":{"date-parts":[[2012,4,3]],"date-time":"2012-04-03T21:41:23Z","timestamp":1333489283000},"page":"1-3","source":"Crossref","is-referenced-by-count":1,"title":["Ain\u2019t No Sunshine When She\u2019s Gone: Pseudohypoparathyroidism Discovered in an Adult"],"prefix":"10.1155","volume":"2012","author":[{"given":"C. R.","family":"van Rooijen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. B.","family":"Kok","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Simsek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands"},{"name":"Department of Internal Medicine, VU University Medical Centre, De Boelelaan 1117, 1007 MB Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Stam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Centre Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"98","reference":[{"key":"1","first-page":"922","volume":"30","year":"1942","journal-title":"Endocrinology"},{"issue":"4","key":"2","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1590\/S0004-27302006000400012","volume":"50","year":"2006","journal-title":"Arquivos Brasileiros de Endocrinologia e Metabologia"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.30271"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1210\/en.2004-0865"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-10-0795"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1048"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1385\/JCD:5:3S:S19"}],"container-title":["Case Reports in Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crie\/2012\/739375.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crie\/2012\/739375.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crie\/2012\/739375.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,20]],"date-time":"2017-06-20T16:40:37Z","timestamp":1497976837000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/crie\/2012\/739375\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012]]},"references-count":7,"alternative-id":["739375","739375"],"URL":"https:\/\/doi.org\/10.1155\/2012\/739375","relation":{},"ISSN":["2090-6501","2090-651X"],"issn-type":[{"value":"2090-6501","type":"print"},{"value":"2090-651X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012]]}}}