Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome

Background: Precocious puberty (PP) is common in children and manifests commonly with increased linear growth. Van Wyk–Grumbach (VWG) syndrome is a rare cause of PP with short stature and delayed bone age. Clinical Description: An 11-year-old girl presented with early menarche, menorrhagia, and stun...

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Main Authors: Mansi Jain, Lavina Patnaik, Pragya Mangla, Nishant Raizada
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-11-01
Series:Indian Pediatrics Case Reports
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Online Access:https://journals.lww.com/10.4103/ipcares.ipcares_35_24
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author Mansi Jain
Lavina Patnaik
Pragya Mangla
Nishant Raizada
author_facet Mansi Jain
Lavina Patnaik
Pragya Mangla
Nishant Raizada
author_sort Mansi Jain
collection DOAJ
description Background: Precocious puberty (PP) is common in children and manifests commonly with increased linear growth. Van Wyk–Grumbach (VWG) syndrome is a rare cause of PP with short stature and delayed bone age. Clinical Description: An 11-year-old girl presented with early menarche, menorrhagia, and stunted height. Examination revealed pallor, dry skin, absence of axillary and pubic hair, and the presence of breast development (Tanner stage 3). A magnetic resonance imaging of the brain by a primary physician revealed a pituitary mass and was referred to neurosurgery, who, however, referred the child to us endocrinologists. Management and Outcome: Standard protocol-wise approach showed short stature with delayed bone age, high levels of thyroid-stimulating hormone, follicle-stimulating hormone and prolactin, raised antithyroid peroxidase antibodies along with multicystic ovaries bilaterally, thus cliniching the diagnosis of VWG Syndrome. The patient was started on levothyroxine and showed remission of symptoms and normalization of thyroid function tests as well as pituitary size. Conclusion: It is important to be aware that VWG syndrome may be a cause of PP in which the increase in size of the pituitary is reversible with initiation of thyroxine therapy along with complete resolution of all symptoms, avoiding unnecessary surgical interventions.
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spelling doaj-art-e8a1ff4fa25445c598d63eb8e813589f2025-08-20T02:22:10ZengWolters Kluwer Medknow PublicationsIndian Pediatrics Case Reports2772-51702772-51892024-11-014423023310.4103/ipcares.ipcares_35_24Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach SyndromeMansi JainLavina PatnaikPragya ManglaNishant RaizadaBackground: Precocious puberty (PP) is common in children and manifests commonly with increased linear growth. Van Wyk–Grumbach (VWG) syndrome is a rare cause of PP with short stature and delayed bone age. Clinical Description: An 11-year-old girl presented with early menarche, menorrhagia, and stunted height. Examination revealed pallor, dry skin, absence of axillary and pubic hair, and the presence of breast development (Tanner stage 3). A magnetic resonance imaging of the brain by a primary physician revealed a pituitary mass and was referred to neurosurgery, who, however, referred the child to us endocrinologists. Management and Outcome: Standard protocol-wise approach showed short stature with delayed bone age, high levels of thyroid-stimulating hormone, follicle-stimulating hormone and prolactin, raised antithyroid peroxidase antibodies along with multicystic ovaries bilaterally, thus cliniching the diagnosis of VWG Syndrome. The patient was started on levothyroxine and showed remission of symptoms and normalization of thyroid function tests as well as pituitary size. Conclusion: It is important to be aware that VWG syndrome may be a cause of PP in which the increase in size of the pituitary is reversible with initiation of thyroxine therapy along with complete resolution of all symptoms, avoiding unnecessary surgical interventions.https://journals.lww.com/10.4103/ipcares.ipcares_35_24multicystic ovariespituitarythyroid-stimulating hormone
spellingShingle Mansi Jain
Lavina Patnaik
Pragya Mangla
Nishant Raizada
Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome
Indian Pediatrics Case Reports
multicystic ovaries
pituitary
thyroid-stimulating hormone
title Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome
title_full Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome
title_fullStr Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome
title_full_unstemmed Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome
title_short Precocious Puberty with Short Stature in a Girl: A Rare Case of Van Wyk–Grumbach Syndrome
title_sort precocious puberty with short stature in a girl a rare case of van wyk grumbach syndrome
topic multicystic ovaries
pituitary
thyroid-stimulating hormone
url https://journals.lww.com/10.4103/ipcares.ipcares_35_24
work_keys_str_mv AT mansijain precociouspubertywithshortstatureinagirlararecaseofvanwykgrumbachsyndrome
AT lavinapatnaik precociouspubertywithshortstatureinagirlararecaseofvanwykgrumbachsyndrome
AT pragyamangla precociouspubertywithshortstatureinagirlararecaseofvanwykgrumbachsyndrome
AT nishantraizada precociouspubertywithshortstatureinagirlararecaseofvanwykgrumbachsyndrome