TITLE:
A Rare Cause of Precocious Puberty and Massive Ovarian Cysts Associated with Hypothyroidism
AUTHORS:
Nabil Moatassim Billah, Hajar El Kouarty, Rachida Dafiri
KEYWORDS:
Van Wyk-Grumbach, Precocious Puberty, Hypothyroidism, Ovarian Cysts
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.6 No.1,
March
25,
2016
ABSTRACT: Van
Wyk-Grumbach syndrome (VWGS) is characterized by juvenile hypothyroidism, delayed
bone age, isosexual precocious puberty and massive ovarian cysts. We report
such a case in a 7-year-old girl who presented with a bilateral pelvic pain,
abdominal distension and signs of hypothyroidism. Physical examination showed a
breast development and lack of pubic and axillary hair. There was no
clitoromegaly. Pelvic ultrasonography and CT scan showed enlarged bilateral multiloculared
multicystics ovarian masses. The pituitary MRI was recommended before an
elevated prolactin, revealed a large sellar and suprasellar mass. The patient
was started on thyroid replacement using L-Thyroxine. Clinically, the patient’s
fatigue, pelvic pain, and abdominal distension are resolved. During the follow-up,
her thyroid functions and serum prolactin normalized within 8 months.
Ultrasonography revealed regression of ovarian cysts in 2 months measuring,
with normal sized ovaries in 14 months.