Van Wyk–Grumbach syndrome associated with pituitary hyperplasia: Case report and literature review.
Main Article Content
Abstract
Background: Hypothyroidism is common in pediatrics and is usually associated with delayed sexual development in untreated prepubertal boys. The association of hypothyroidism, precocious puberty, delayed growth, and bone age was initially described by Van Wyk and Grumbach in 1960. Some cases present pituitary hyperplasia and ovarian cysts. Case report: the case of an 8-year-old girl with early menarche, short stature, and pituitary hyperplasia caused by hypothyroidism is presented. She receives treatment with levothyroxine, with improvement in her growth rate, the disappearance of vaginal bleeding, and pituitary hyperplasia. Conclusion: knowledge about the syndrome contributes to timely diagnosis and treatment, which significantly improves the prognosis of growth and development of the child, and avoids subjecting him to unnecessary surgical procedures.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
You are free to:
Share - copy and redistribute the material in any medium or format.
Adapt - remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
• ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
• No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
References
Ghaemi N, Vakili R, Bagheri S. Precocious Puberty: An Unusual Presentation of Hypothyroidism. Int J Pediatr. 2013;1(2):51–4.
Van Wyk JJ, Grumbach MM. Syndrome of precocious menstruation and galactorrhea in juvenile hypothyroidism: an example of hormonal overlap in pituitary feedback. J Pediatr. 1960 Sep 1;57(3):416–35. DOI: https://doi.org/10.1016/S0022-3476(60)80250-8
Kocova M, Netkov S, Sukarova-Angelovska E. Pituitary pseudotumor with unusual presentation reversed shortly after the introduction of thyroxine replacement therapy. J Pediatr Endocrinol Metab. 2001 Nov;14(9):1665–9. DOI: https://doi.org/10.1515/JPEM.2001.14.9.1665
Matti M, Joshi S. Van Wyk-Grumbach syndrome: A Rare Result of Prolonged Hypothyroidism [Internet]. Vol. 11, Pediatric Oncall. 2014. Available from: http://dx.doi.org/10.7199/ped.oncall.2014.46 DOI: https://doi.org/10.7199/ped.oncall.2014.46
Shivaprasad KS, Dutta D, Jain R, Kumar M, Maisnam I, Biswas D, et al. Huge bilateral ovarian cysts in adulthood as the presenting feature of Van Wyk-Grumbach syndrome due to chronic uncontrolled juvenile hypothyroidism. Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S164–6. DOI: https://doi.org/10.4103/2230-8210.119559
Eom KS, See-Sung C, Kim JD, Kim JM, Kim TY. Primary hypothyroidism mimicking a pituitary macroadenoma: regression after thyroid hormone replacement therapy. Pediatr Radiol. 2009 Feb;39(2):164–7. DOI: https://doi.org/10.1007/s00247-008-1012-9
Cabrera SM, DiMeglio LA, Eugster EA. Incidence and characteristics of pseudoprecocious puberty because of severe primary hypothyroidism. J Pediatr. 2013 Mar;162(3):637–9. DOI: https://doi.org/10.1016/j.jpeds.2012.10.043
Asirvatham AR, Mahadevan S, Balachandran K, Balasubramaniam SK. Van Wyk–Grumbach syndrome: A case series and review of literature. IJSR - International Journal of Scientific Research [Internet]. 2018 [cited 2021 May 8];7 Issue 2. Available from: https://www.worldwidejournals.com/international-journal-of-scientific-research-(IJSR)/article/van-wykandndash-grumbach-syndrome-a-case-series-and-review-of-literature/MTQxNTg=/?is=1
Bhansali A, Kashyap A, Lodha S, Kotwal N, Ganapathi B, Mittal BR, et al. Isosexual precocity: uncommon presentation of a common disorder. Postgrad Med J. 2000 Mar;76(893):177–8. DOI: https://doi.org/10.1136/pmj.76.893.177
Omran A, Peng J, Shrestha B, Ashhab MU, Yin F. Male Child with Van Wyk-Grumbach’s Syndrome and Other Complications of Long-Standing Primary Hypothyroidism: A Case Report [Internet]. Vol. 2012, Case Reports in Pediatrics. 2012. p. 1–5. Available from: http://dx.doi.org/10.1155/2012/352751 DOI: https://doi.org/10.1155/2012/352751
Moreno-Guzmán LS, Sandoval-Benítez M, Núñez-Hernández JA, Sánchez-Castillo JL. Virilización secundaria a hiperandrogenismo ovárico en síndrome de Van Wyk-Grumbach: reporte de un caso. Arch Inv Mat Inf. 2016 Aug 15;7(3):104–6.
Bassam T, Ajlouni K. A case of ovarian enlargement in severe primary hypothyroidism and review of the literature. Ann Saudi Med. 2006 Jan;26(1):66–8. DOI: https://doi.org/10.5144/0256-4947.2006.66
Patni N, Cervantes LF, Diaz A. Elevated alpha-fetoprotein levels in Van Wyk-Grumbach syndrome: a case report and review of literature. J Pediatr Endocrinol Metab. 2012;25(7-8):761–7. DOI: https://doi.org/10.1515/jpem-2012-0112