Van wyk-grumbach syndrome: an unusual presentation of long standing hypothyroidism with early menarche.

Abstract

Hypothyroidism is generally associated with delayed puberty, but long standing untreated hypothyroidism in young children can lead to pseudo-precocious puberty. Hypothyroidism induced precocious puberty presents with thelarche, menarche, galactorrhea, absence of sexual hair, delayed bone growth also known as van wyk-grumbach syndrome. Here we report an 8 years old girl presented to us with history of cyclical per vaginal bleeding since age of 3 years. Upon further workup there were bilateral polycystic ovaries on ultrasonography, upon subsequent investigations child was diagnosed with hypothyroidism.Due to lack of neonatal screeing for hypothyroisdim,lack of awareness among genral population such cases are missed and often presents late to healthcare pfofessionals.