Severe menorrhagia, unilateral ovarian mass, elevated inhibin levels, and severe hypothyroidism

An unusual presentation of Van Wyk and Grumbach syndrome

Sifrance Tran, Ellen E. Kim, Anthony C. Chin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
Volume48
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

Fingerprint

Menorrhagia
Inhibins
Hypothyroidism
Observation
Granulosa Cell Tumor
Precocious Puberty
Uterine Hemorrhage
antineoplaston A10
Hormone Replacement Therapy
Tumor Biomarkers
Thyroid Hormones
Abdominal Pain
Fatigue
Thyroid Gland
Therapeutics
inhibin A
Autoimmune Hypothyroidism
inhibin B

Keywords

  • Hypothyroidism
  • Inhibin A
  • Inhibin B
  • Ovarian mass
  • Tumor markers
  • Van Wyk-Grumbach syndrome

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Severe menorrhagia, unilateral ovarian mass, elevated inhibin levels, and severe hypothyroidism: An unusual presentation of Van Wyk and Grumbach syndrome",
abstract = "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.",
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T1 - Severe menorrhagia, unilateral ovarian mass, elevated inhibin levels, and severe hypothyroidism

T2 - An unusual presentation of Van Wyk and Grumbach syndrome

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AU - Kim, Ellen E.

AU - Chin, Anthony C.

PY - 2013/1

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N2 - 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.

AB - 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.

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KW - Inhibin A

KW - Inhibin B

KW - Ovarian mass

KW - Tumor markers

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