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The calcium-sensing receptor (CaSR) is a Class C G-protein coupled receptor which senses extracellular levels of calcium ions. It is primarily expressed in the parathyroid gland, the renal tubules of the kidney and the brain. [5] [6] In the parathyroid gland, it controls calcium homeostasis by regulating the release of parathyroid hormone (PTH ...
However, because calcium is absorbed rather inefficiently by the intestines, high serum calcium is more likely caused by excessive secretion of parathyroid hormone (PTH) or possibly by excessive intake of vitamin D, both of which facilitate calcium absorption.
The diagnosis is based on the presence of the Albright hereditary osteodystrophy pseudotype but without the PTH resistance. Blood tests including calcium, phosphate, and PTH will exclude other forms of pseudohypoparathyroidism. X-rays may reveal a short fourth metacarpal. Genetic testing can confirm the diagnosis by showing GNAS gene mutation. [1]
In earlier stages, serum calcium, phosphate levels are normal at the expense of high parathyroid hormone and fibroblast growth factor-23 levels. X-rays will also show bone features of renal osteodystrophy (subperiostic bone resorption, chondrocalcinosis at the knees and pubic symphysis , osteopenia and bone fractures) but may be difficult to ...
The parathyroid gland produces and secretes parathyroid hormone in response to low blood calcium, which plays a key role in regulating the amount of calcium in the blood and within the bones. Parathyroid glands share a similar blood supply, venous drainage, and lymphatic drainage to the thyroid glands.
It acts to reduce blood calcium (Ca 2+), opposing the effects of parathyroid hormone (PTH). [7] Its importance in humans has not been as well established as its importance in other animals, as its function is usually not significant in the regulation of normal calcium homeostasis. [8] It belongs to the calcitonin-like protein family.
Serum calcium levels are usually elevated, and the parathyroid hormone level is abnormally high compared with an expected low level in response to the high calcium. A relatively elevated parathyroid hormone has been estimated to have a sensitivity of 60–80% and a specificity of approximately 90% for primary hyperparathyroidism. [9]
The Chvostek sign (/ ˈ k v ɒ s t ɪ k /) is a clinical sign that someone may have a low blood calcium level (a decreased serum calcium, called hypocalcemia).The Chvostek sign is the abnormal twitching of muscles that are activated (innervated) by the facial nerve (also known as Cranial Nerve Seven, or CNVII). [1]
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