A child with hypocalcemia – Looking for the bedside clues!

Abstract

A 4-year 2-month-old girl presented with painful spasms in both hands and feet. She was noticed to have excessive weight gain and mild developmental delay and was diagnosed with hypothyroidism during infancy. She had a stocky build and round facies, brachydactyly, and subcutaneous calcification. Laboratory investigations showed low serum calcium, high serum phosphorus, and elevated intact PTH levels. A provisional diagnosis of pseudohypoparathyroidism was made.