|A Rare Case Report of Idiopathic Primary Hypoparathyroidism Coexisting with Shortening of Third to Fifth Metacarpal Bones|
|Mohammad Amin Dolatkhah1, Ali Saadati Shamir2, Majid Shokoohi1, Hossein Kalarestaghi1,3, Ali Delshad Noghabi4, Seyyed Mostafa Ghavami5, Nazila Asgharan6, Hamed Shoorei1|
|1Department of Anatomical Sciences, Faculty of Medicine,Tabriz University of Medical Sciences, Tabriz, Iran
2Department of Radiology, Faculty of Paramedical, Birjand University of Medical Sciences, Birjand, Iran
3Department of Anatomy and Pathology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
4Department of Nursing, Faculty of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran
5Department of Radiology, Faculty of Paramedical, Tabriz University of Medical Sciences, Tabriz, Iran
6Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Keywords : Albright's hereditary osteodystrophy, Pseudohypoparathyroidism, Pseudopseudohypoparathyroidism, Idiopathic primary hypoparathyroidism, Brachydactyly type E
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A 20-year-old Iranian male after injury in a football match with pain of the finger was referred to the hospital. His hand X-Ray images showed no fractures, but the shortening of third to fifth metacarpal bones was clearly observed. The short metacarpal sign is a very helpful diagnostic method in patients suffering fromidiopathic hypoparathyroidism (IHP), pseudohypoparathyroidism type Ia (PHP-Ia) with Albright's hereditary osteodystrophy (AHO) phenotype, pseudopseudohypoparathyroidism (PPHP), and brachydactyly type E. Briefly, in Hypoparathyroidism disease, the serum calcium level decrease and the serum phosphorus level increase in blood. PHP-Ia disorder is clinically similar to hypoparathyroidism; in this disease, the level of parathyroid hormone is normal but there is resistance to parathyroid hormone. PPHP diseaseis not an endocrine disorder but is related to PHP-Ia.in this disease, serum levels of calcium and phosphorus in blood are normal, alsosymptoms and signs in PPHP are similar to PHP-Ia, but there is no resistance to parathyroid hormone.In brachydactyly type E, shortening of metacarpal or metatarsal bones is caused by abnormal development of phalanxes, metacarpals, or both. His laboratory tests revealed a low serum calcium level, high serum phosphate, and low serum PTH level therefore a diagnosis of IHP was reached.
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