Hypothyroidism (Hypoparathyroidism): Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Pseudohypoparathyroidism (synonym: Martin-Albright syndrome) – genetic disorder with autosomal dominant inheritance; symptoms of hypoparathyroidism (hypothyroidism) without a deficiency of parathyroid hormone (PTH) in the blood: four types are distinguished according to appearance:
    • Type Ia: simultaneously exists an Albright osteodystrophy: brachymetacarpy (shortening of single or multiple metacarpal bones) and -tarsia (shortening of single or multiple metatarsal bones), round face, short stature.
    • Type Ib; as in type 1a, there is renal PTH resistance, resistance to other hormones, especially thyrotropin are also possible; there is no Albright osteodystrophy
    • Type Ic: identical to type 1a, except that receptor-independent cAMP production is preserved in vitro.
    • Type II: probably several subtypes, Albright osteodystrophy is not present.
  • Pseudo-pseudohypoparathyroidism – when family members of pseudohypoparathyroidism sufferers have typical organic stigmata such as shortening of metacarpals/metatarsals or stocky build, but no calcium disorder.

Endocrine, nutritional and metabolic disorders (E00-E90).

  • Hypocalcemia (calcium deficiency) of other cause (parathyroid hormone (PTH) intact: not decreased) – the following syndromes may be considered:
    • Acute pancreatitis (inflammation of the pancreas).
    • Malabsorption syndrome (diseases caused by impaired absorption of substrates from the intestine).
    • Peritonitis (inflammation of the peritoneum (peritoneum)).
    • Healing phase of rickets (reduced mineralization of bones with a tendency to spontaneous fractures (spontaneous bone fracture) and bone bending) or osteomalacia (bone softening).
    • Renal insufficiency (kidney weakness)
    • Infusion of EDTA (ethylenediaminetetraacetate; complexing agent) or citrate blood.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Normocalcemic tetany (tetany associated with normal blood calcium levels) – most common; here, there is a decrease in ionized calcium due to alkalosis (disturbance of acid-base balance leading to an increase in blood pH; usually respiratory (breathing-related) alkalosis due to psychogenic hyperventilation (increased respiratory rate)).