Van Wyk and Grumbach syndrome revisited: imaging and clinical findings in pre- and postpubertal girls
- Lorna P. BrowneAffiliated withDepartment of Diagnostic Imaging, Texas Children’s Hospital Email author
- , Hillary B. BoswellAffiliated withDepartment of Gynecology, Texas Children’s Hospital
- , Eric J. CrottyAffiliated withDepartment of Radiology, Cincinnati Children’s Hospital Medical Center
- , Sara M. O’HaraAffiliated withDepartment of Radiology, Cincinnati Children’s Hospital Medical Center
- , Krista L. BirkemeierAffiliated withDepartment of Radiology, Cincinnati Children’s Hospital Medical Center
- , R. Paul GuillermanAffiliated withDepartment of Diagnostic Imaging, Texas Children’s Hospital
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In 1960 Van Wyk and Grumbach described a syndrome of juvenile hypothyroidism, precocious puberty and ovarian enlargement. These findings undergo complete regression with thyroid hormone replacement therapy. This diagnosis can be made on the basis of imaging findings and thyroid function analysis, avoiding surgery.
To relate the distinctive clinical and imaging features and putative pathophysiological mechanism of a series of patients with Van Wyk and Grumbach syndrome (VWGS).
Materials and methods
Patients with VWGS diagnosed at two large children’s hospitals over a 6-year period beginning in 1999 were retrospectively reviewed. A literature review was also conducted.
Five female patients were diagnosed with cystic ovarian enlargement and hypothyroidism at ages ranging from 9 to 17 years. Isosexual precocious puberty was found in prepubescent patients. Associated findings included delayed bone age, ascites, and pleural and pericardial effusions. Ovarian cyst involution occurred following treatment of the hypothyroidism.
The association of primary hypothyroidism with cystic ovarian enlargement and precocious puberty is important to recognize. In the absence of suspected ovarian torsion, surgery is unnecessary, as cyst regression occurs after appropriate thyroid hormone replacement. Noncompliance with hormone replacement therapy should be considered when cystic ovarian enlargement is noted in patients with a history of hypothyroidism.
KeywordsVan Wyk and Grumbach syndrome Ovarian cyst Precocious puberty Hypothyroidism
- Van Wyk and Grumbach syndrome revisited: imaging and clinical findings in pre- and postpubertal girls
Volume 38, Issue 5 , pp 538-542
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- Van Wyk and Grumbach syndrome
- Ovarian cyst
- Precocious puberty
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- Author Affiliations
- 1. Department of Diagnostic Imaging, Texas Children’s Hospital, 6621 Fannin St., Houston, TX, 77030, USA
- 2. Department of Gynecology, Texas Children’s Hospital, Houston, TX, USA
- 3. Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA