Sir.—We read with interest the report by Balachandar et al in the September issue of the Journal (129:1092, 1975) describing a boy with pseudohypoparathyroidism and normal serum calcium level.
We have studied a family in which four (three girls and one boy) of the five children have pseudohypoparathyroidism. The mother of the patients has pseudo-pseudohypoparathyroidism and the father is healthy.1.2
This observation is informative with respect to several points:
All patients have had severe attacks of hypocalcemic tetany in early infancy. At present, with the patients at ages 14, 13, and 11 years, respectively, plasma calcium levels are normal, without any specific therapy. Plasma inorganic phosphate levels remain high (6.0 to 6.5 mg/100 ml).
There is no roentgenographic evidence of anomalies of bone texture. Histological studies in three patients show signs of hyperparathyroidism, such as subperiosteal lacunas of bone resorption filled with osteoclasts and fibrous tissue.