DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20221954

A rare case of ovarian hyperstimulation with torsion presenting with hypothyroidism

Kruthiga Kumari Balasubramanian, Pavai Arunachalam

Abstract


A thirteen years old female child, who was recently diagnosed with hypothyroidism and polycystic ovary and under thyroid supplements, presented with acute abdominal pain of one day duration. Examination showed pallor with rough skin, hypotension (70/40 mmHg) and distended abdomen. Abdomen was tense with tenderness and guarding. Urgent contrast CT abdomen showed bilateral polycystic ovaries with left ovarian torsion and hemo-peritoneum. Blood investigations showed anemia (6.0 g/dL) and TSH >100 microIU/ml. She was stabilized with Intravenous fluids, packed red blood cells and taken up for surgery. Laparoscopy confirmed the diagnosis and detorsion with deroofing of cysts was done. A post-operative diagnosis of Van Wyk Grumbach syndrome - Hypothyroidsm with ovarian hyper stimulation syndrome with hemorrhagic torsion of left ovary was made. She withstood procedure well and was stable. She was discharged to a local hospital after 2 days of surgery. She is on thyroid supplements and doing well.


Keywords


Van Wyk Grumbach syndrome, Hypothyroidism, Precocious puberty, Hyperprolactinemia, Laparoscopic deroofing and detorsion

Full Text:

PDF

References


Van WYK, Durbin KL, Diaz-Montes T, Loveless MB. Grumbach syndrome: an unusual case and review of the literature. J Pediatr Adolesc Gynecol. 2011;24(4):e93-6.

Lafranchi S. Disorders of thyroid gland. in: Kliegman MR, et al. Nelson textbook of pediatrics. 19th ed. Philadelphia: Saunders; 2011:1894-918.

Bhatia R. Van Wyk Grumbach syndrome: a case report. Int J Contemp Pediatr. 2016;3(1):262-3.

Rastogi A, Bhadada S, Bhansali A. An unusual presentation of a usual disorder: Van Wyk Grumbach Syndrome. Indian J endocrinol Metab. 2011;15(2):141-3.

Baranowski E, Hogler W. An unusual presentation of acquired hypothyroidism: the van wyk grumbach syndrome. Eur J Endocrinol. 2012;166(3):537-42.

Sneha LM, Thanasegarapandian K, Paramasivam, V, Scott J. Short Stature an interesting association. Indian J Hum Genet. 2013;19(1):101-3.

Van Wyk JJ, Grumbach MM. Syndrome of precocious menstruation and galactorrhoea in juvenile hypothyroidism: an example of hormonal overlap in pituitary feedback. J Pediatrics. 1960;57(3):416-35.

Browne LP, Boswell HB, Crotty EJ, OHara SM, Birkemeier KL, Guillerman RP, et al. Grumbach syndrome revisited: Imaging and clinical findings in pre- and postpubertal girls. Pediatr Radiol. 2008;38(5):538-42.

Chu JY, Monteleone JA, Peden VH, Graviss ER, Vernava BS. Anaemia in children and adolescents with hypothyroidism. Clinical Paediatrics. 1981;20(11):696-9.