Clinical review: Pseudohypoparathyroidism: diagnosis and treatment

J Clin Endocrinol Metab. 2011 Oct;96(10):3020-30. doi: 10.1210/jc.2011-1048. Epub 2011 Aug 3.


Context: The term pseudohypoparathyroidism (PHP) indicates a group of heterogeneous disorders whose common feature is represented by impaired signaling of various hormones (primarily PTH) that activate cAMP-dependent pathways via Gsα protein. The two main subtypes of PHP, PHP type Ia, and Ib (PHP-Ia, PHP-Ib) are caused by molecular alterations within or upstream of the imprinted GNAS gene, which encodes Gsα and other translated and untranslated products.

Evidence acquisition: A PubMed search was used to identify the available studies (main query terms: pseudohypoparathyroidism; Albright hereditary osteodystrophy; GNAS; GNAS1; progressive osseous heteroplasia). The most relevant studies until February 2011 have been included in the review.

Evidence synthesis and conclusions: Despite the first description of this disorder dates back to 1942, recent findings indicating complex epigenetic alterations beside classical mutations at the GNAS complex gene, pointed out the limitation of the actual classification of the disease, resulting in incorrect genetic counselling and diagnostic procedures, as well as the gap in our actual knowledge of the pathogenesis of these disorders. This review will focus on PHP type I, in particular its diagnosis, classification, treatment, and underlying molecular alterations.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chromogranins
  • Fibrous Dysplasia, Polyostotic / diagnosis
  • Fibrous Dysplasia, Polyostotic / therapy
  • GTP-Binding Protein alpha Subunits, Gs / genetics
  • GTP-Binding Protein alpha Subunits, Gs / physiology
  • Humans
  • Parathyroid Hormone / physiology
  • Pseudohypoparathyroidism / classification
  • Pseudohypoparathyroidism / diagnosis*
  • Pseudohypoparathyroidism / genetics
  • Pseudohypoparathyroidism / physiopathology
  • Pseudohypoparathyroidism / therapy*


  • Chromogranins
  • Parathyroid Hormone
  • GNAS protein, human
  • GTP-Binding Protein alpha Subunits, Gs