{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T17:51:53Z","timestamp":1772992313373,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":324,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Endocrinology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>Pseudohypoparathyroidism (PHP) is a metabolic disorder that occurs due to target end\u2010organ resistance to parathyroid hormone (PTH). It is a rare cause of severe symptomatic hypocalcemia as it characteristically manifests with high phosphate and low calcium. The clinical presentation, biochemical features, and severity vary from patient to patient leading to delay in diagnosis. Reduced awareness and lack of recognition of this rare clinical syndrome coupled with limited resources in rural health facilities also contribute to missed or late diagnosis. Reported here is a case of a 13\u2010year\u2010old girl who presented in a rural county hospital with a 1\u2010year duration of muscle twitching and persistent headache. She had been managed with anticonvulsant therapy without resolution. Upon admission to our facility calcium levels were noted to be very low with high phosphate, high PTH levels, and normal vitamin D levels. The brain CT scan revealed calcifications in the basal ganglia. A diagnosis of PHP was henceforth made. She was put on intravenous calcium gluconate with subsequent oral calcium and calcitriol with resultant resolution of twitching. This case points to delayed diagnosis of a rare cause of symptomatic hypocalcemia signifying importance of early biochemistry testing and careful interpretation in a patient presenting with persistent twitching in low\u2010resource set ups.<\/jats:p>","DOI":"10.1155\/crie\/5272560","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T10:58:46Z","timestamp":1763722726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pseudohypoparathyroidism Presenting With Recurrent Twitching: Challenges Making a Diagnosis in a Low\u2010Resource Environment"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3708-5488","authenticated-orcid":false,"given":"Phoebe","family":"Wamalwa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9798-3696","authenticated-orcid":false,"given":"Prisca","family":"Amolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39582.589433.BE"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/2042018810366494"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra070553"},{"key":"e_1_2_11_4_2","unstructured":"LofreseJ. J. BasitH. andLappinS. L. Physiology Parathyroid StatPearls 2025 StatPearls Publishing Treasure Island (FL) https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK482510\/."},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.77.1.609"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.18203\/2349-3291.ijcp20221384"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00774-009-0119-x"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0042-0"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000491045"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab060"},{"key":"e_1_2_11_11_2","volume-title":"Pseudohypoparathyroidism","author":"Ucciferro P.","year":"2023"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI167953"},{"key":"e_1_2_11_13_2","volume-title":"Endotext [Internet]","author":"Bastepe M.","year":"2000"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.03025.x"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1497"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.31.10.779"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199005173222002"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1080\/08958378.2019.1705940"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgae800"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2000.15.7.1412"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.928284"},{"key":"e_1_2_11_22_2","unstructured":"World Health Organization World Health Report 2000 2000 WHO Geneva."}],"container-title":["Case Reports in Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crie\/5272560","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crie\/5272560","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crie\/5272560","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T13:51:06Z","timestamp":1772977866000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crie\/5272560"}},"subtitle":[],"editor":[{"given":"Osamu","family":"Isozaki","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/crie\/5272560"],"URL":"https:\/\/doi.org\/10.1155\/crie\/5272560","archive":["Portico"],"relation":{},"ISSN":["2090-6501","2090-651X"],"issn-type":[{"value":"2090-6501","type":"print"},{"value":"2090-651X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5272560"}}