delayed contraction and relaxation of reflexes, and percussion myxedema. Objectives: To diagnose the rare association of VWGS and KDSS and to conduct a follow-up of the patient on replacement therapy. Methods: We present a case of a 9-year-old female child who presented to the endocrine department with complaints of intermittent vaginal bleeding, short stature, and difficulty in walking. On evaluation she was found to be having autoimmune hypothyroidism, FSH-dominated isosexual pseudoprecocious puberty, delayed bone age, secondary pituitary macroadenoma, delayed relaxation of deep tendon reflexes, and pseudohypertrophy of calf muscles. The diagnosis of VWGS associated with KDSS was made. The patient was initially put on 25 μg thyroxine replacement, which was titrated accordingly, and was followed up after 6 months and 1 year. Results: All the
Key WordsVan Wyk-Grumbach syndrome · Juvenile hypothyroidism · Isosexual pseudoprecocious puberty · Multicystic ovaries · Kocher-Debré-Sémélaigne syndrome Abstract Background: Van Wyk-Grumbach syndrome (VWGS) is a rare presentation of juvenile hypothyroidism which manifests in females as chronic autoimmune hypothyroidism, isosexual pseudoprecocious puberty, and multicystic ovaries. It uniquely presents with short stature and delayed bone age unlike other causes of precocious puberty. Kocher-Debré-Sémélaigne (KDSS) is a rare presentation of juvenile hypothyroidism manifesting as calf muscle pseudohypertrophy,
What Is Known about This Topic?• Van Wyk-Grumbach and Kocher-Debré-Sémélaigne syndromes are two rare presentations of primary hypothyroidism in pediatric patients. Only a single case of the simultaneous occurrence of these two syndromes has been described in the medical literature.
What Does This Case Report Add?• This is the second description of the simultaneous occurrence of these rare syndromes, and we have shown that their manifestations fully resolve by thyroxine treatment without any sequelae.