Pseudohypoparathyroidism type Ia (PSP) is a disorder characterized by Albright's osteodystrophy, secondary hyperparathyroidism, lowered G s activity, and resistance of the urinary cAMP excretion to exogenous PTH. The patients had raised basal serum levels of TSH and/or excessive TSH response to TRH. Here we have described a 38-bp deletion at the exon 1/intron 1 boundary of one G s ␣ allele in two mothers with pseudo-PSP and in six offsprings with PSP of a kindred with Albright's osteodystrophy. The deletion eliminates the splice donor site of exon 1. The pseudo-PSP patients presented decreased G s activity, but normal urinary cAMP responses to PTH and normal TSH levels and responses to TRH. As monitored during 22 yr, they had normal serum levels of calcium and PTH. The findings demonstrate the same inherited functional defect of G s ␣ in two female patients with pseudo-PSP and in six of their offspring with PSP. The pathogenesis of clinical hypoparathyroidism remains to be clarified. (J Clin Endocrinol Metab 83: 935-938, 1998) P SEUDOHYPOPARATHYROIDISM Ia (PSP) is a disorder with clinical hypoparathyroidism and the phenotype of Albright's osteodystrophy, but raised plasma levels of bioactive and immunoreactive PTH (1; see Ref. 2 for additional references). Patients with PSP frequently present raised serum levels of TSH and excessive TSH response to TRH with sometimes overt clinical hypothyroidism (3 and references cited therein). The diagnosis of PSP-Ia was established on the basis of resistance of the urinary cAMP excretion to exogenous PTH, and decreased guanine nucleotidebinding protein G s activity (4 -10). G s activity was decreased in the PSP patients reported here, but it was similarly decreased in their mothers with pseudo-PSP (8). The latter responded normally to exogenous PTH with raised urinary cAMP excretion; secondary hyperparathyroidism and excessive TSH response to TRH were not observed. A functional deficiency of G s has been reported in PSP and pseudo-PSP (8 -10).A genetic deficiency of G s ␣ has been revealed in familial PSP and pseudo-PSP (11-15; for additional mutations, see Ref. 16). As shown here, the patients with PSP-Ia as well as those with pseudo-PSP carry a novel deletion in one G s ␣ allele resulting in reduced G s ␣ activity. In healthy siblings with no signs of Albright's osteodystrophy, both G s ␣ alleles were normal. It would seem, therefore, that the described genetic defect, resulting in reduced G s ␣ activity, is not an obvious cause of the resistance to exogenous PTH in the kindred reported here.