Severe menorrhagia, unilateral ovarian mass, elevated inhibin levels, and severe hypothyroidism: an unusual presentation of Van Wyk and Grumbach syndrome.

Abstract

A 10 year old female presented with a 3 week history of persistent vaginal bleeding, lower abdominal pain, and generalized fatigue. Further work-up determined that she had severe autoimmune hypothyroidism, precocious puberty, and a large left cystic ovarian mass, consistent with Van Wyk and Grumbach syndrome. In addition, the patient had elevated inhibin A and B levels, which may be elevated in granulosa cell tumor. The patient was managed with thyroid hormone replacement therapy and careful observation. Complete resolution of the ovarian mass and interval normalization of the inhibin levels were achieved. In females with severe primary hypothyroidism, ovarian masses, and elevated tumor markers, operative resection may be avoided with appropriate thyroid replacement therapy and close observation.

• Authors: Sifrance Tran, Ellen E Kim, Anthony C Chin
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 48 Issue 1 Pg. e51-4 (Jan 2013) ISSN: 1531-5037 [Electronic] United States
• PMID: 23331842 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• inhibin A
• inhibin B
• Inhibins

Topics

• Biomarkers (blood)
• Child
• Female
• Hashimoto Disease (blood, diagnosis)
• Humans
• Inhibins (blood)
• Menorrhagia (blood, diagnosis)
• Ovarian Cysts (blood, diagnosis)
• Puberty, Precocious (blood, diagnosis)
• Syndrome
• Thyroiditis, Autoimmune