Hypoparathyroidism is most commonly caused by surgery for parathyroid disease, thyroid disease, or extensive head and neck tumors. Patients with hypoparathyroidism often display signs and symptoms of hypocalcemia and exhibit diminished serum calcium, elevated serum phosphorus, and reduced serum PTH. In contrast, patients with the rare disorder PHP manifest functional hypoparathyroidism with hypocalcemia and hyperphosphatemia, yet they exhibit elevated PTH levels due to PTH resistance rather than PTH deficiency. The basis of the PTH resistance is decreased Gsa activity, resulting in impaired signaling through a number of hormonal receptors, including the PTH receptor. Severe hypocalcemia resulting from any cause can be life threatening; therefore, establishing the appropriate diagnosis and initiating prompt therapy are critical. Close monitoring is indicated to determine if long-term therapy is necessary.


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