title: Familial association of pseudohypoparathyroidism and psoriasis: case report.
abstract: BACKGROUND
  The association between psoriasis and hypoparathyroidism has been reported by several authors, and it has been suggested that abnormalities in calcium homeostasis may be involved in the development or exacerbation of psoriasis. However, so far there have only been two reports of pseudohypoparathyroidism associated with psoriasis.
  
  
  OBJECTIVE
  To describe the familial occurrence of this association for the first time.
  
  
  METHODS
  Two siblings with psoriasis associated with pseudohypoparathyroidism were presented. The first patient was a 24-year-old white male with disseminated erythrodermic pustular psoriasis that began 2 months before admission. He had had a history of mental retardation, recurrent otitis, seizures and arthralgia from the age of 11 years onwards. He presented the characteristic phenotype of Albright osteodystrophy: short stature, obesity, round facies, broad forehead, short neck and brachydactylia. He adopted a position of flexed limbs and showed proximal muscle weakness and a positive Trousseau sign. He had clinical signs of hypocalcemia (0.69 mmol/l ionized calcium and 3.2 mg/dl total calcium), hyperphosphatemia (6.6 mg/dl), hypomagnesemia (1.0 mEq/l), hypoalbuminemia (3.1 g/dl), normal serum intact PTH levels (45.1 pg/ml), primary hypothyroidism (13.2 mU/ml TSH, and 4.7 mg/dl total T(4)), hypergonadotrophic hypogonadism (116.0 ng/ml LH, 13.2 mU/ml FSH and 325.0 ng/dl testosterone), osteoporosis, and diffuse calcifications in soft tissues and in the central nervous system. The second case was a 14-year-old white girl with a history of psoriasis vulgaris from the age of five years onwards, and antecedents of mental retardation. She presented signs of Albright osteodystrophy (short stature, round facies, obesity, short neck, brachydactylia), hypocalcemia (ionized calcium of 1.08 mmol/l and total calcium of 6.7 mg/dl) hyperphosphatemia (9.4 mg/dl), elevated serum PTH levels (223.0 pg/ml), osteoporosis, and hypergonadotrophic hypogonadism (7.0 mU/ml LH, 9.3 mU/ml FSH and undetectable estradiol levels).
authors.affiliation: Endocrinology and Metabolism Division, Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo, Avenida Bandeirantes 3900, Ribeirão Preto/SP, Brazil-CEP 14048-900.
authors.forename: Renan Magalhães
authors.initials: RM
authors.lastname: Montenegro
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Albuquerque de Paula
authors.forename: Norma Tiraboshi
authors.initials: NT
authors.lastname: Foss
authors.forename: Milton Cesar
authors.initials: MC
authors.lastname: Foss
mesh_terms: D000015:Abnormalities, Multiple; D000293:Adolescent; D000328:Adult; D002119:Calcium Carbonate / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D009679:Nuclear Family; D011547:Pseudohypoparathyroidism / Q000150:complications* / Q000235:genetics; D011565:Psoriasis / Q000188:drug therapy / Q000209:etiology* / Q000235:genetics
chemical_list: D002762:Cholecalciferol; D002119:Calcium Carbonate