Improvement in abnormal secretion of thyrotropin and gonadotropin after restoration of serum calcium is pseudohypoparathyroidism.

A 25 yr-old woman patient was admitted because of convulsion. The diagnosis of pseudohypoparathyroidism was made on the basis of typical stigmata, lowered serum calcium, increased serum phosphorus and parathyroid hormone levels, and defective response in urinary excretion of cyclic AMP and phosphorus to exogenous parathyroid extract. Endocrine studies performed in the hypocalcemic state revealed several abnormalities of the pituitary gland such as an exaggerated response of TSH to TRH, high basal levels and exaggerated responses of LH/FSH and a blunted GH response to arginine-HCl, while there was no clinical evidence of hypothyroidism and hypogonadism. These abnormalities of anterior pituitary function were normalized after the restoration of normocalcemia by using 1 alpha-hydroxy-cholecalciferol. These results suggest that some endocrine abnormalities observed in pseudohypoparathyroidism might be functional and reversible disorders secondary to hypocalcemia rather than genetic ones.