• Adel Mandl, Peter D Burbelo, Giovanni Di Pasquale, You Sher Tay, James Welch, Michail S Lionakis, Sergio D Rosenzweig, Meryl A Waldman, Blake M Warner, Brian Walitt, Michael T Collins, James E Balow, John A Chiorini, William F Simonds, Sunita K Agarwal, Jenny E Blau, and Lee S Weinstein.
• From the Metabolic Diseases Branch (A.M., J.W., W.F.S., S.K.A., J.E.B., L.S.W.) and the Kidney Diseases Branch (M.A.W., J.E.B.), National Institute of Diabetes and Digestive and Kidney Diseases, the Adeno-Associated Virus Biology Section (P.D.B., G.D.P., J.A.C.), Salivary Disorders Unit (B.M.W.), and Skeletal Disorders and Mineral Homeostasis Section (M.T.C.), National Institute of Dental and Craniofacial Research, the Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases (M.S.L.), the Symptom Management Branch, National Institute of Nursing Research (B.W.), and the Department of Laboratory Medicine, Clinical Center (S.D.R.), National Institutes of Health, Bethesda, MD; and Kaiser Permanente, Sacramento, CA (Y.S.T.).
• N. Engl. J. Med. 2021 Nov 18; 385 (21): 197419801974-1980.

AbstractWe describe two cases of acquired parathyroid hormone (PTH) resistance consequent to the development of serum PTH type 1 receptor (PTH1R) autoantibodies, which block PTH binding and signaling. Both cases were associated with other autoimmune manifestations, and one case was associated with atypical membranous glomerulonephritis. In vitro binding and signaling assays identified the presence of PTH1R-blocking IgG autoantibodies, which were not present in serum samples from patients with other renal or autoimmune disorders. (Funded by the Intramural Research Programs of the National Institute of Diabetes and Digestive and Kidney Diseases and others.).Copyright © 2021 Massachusetts Medical Society.

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