Sexual Maturation in Juvenile Hypothyroidism

Barnes, N. D.; Hayles, Alvin B.; Ryan, Robert J.

doi:10.1097/00006254-197409000-00021

Cited by 14 publications

(24 citation statements)

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“…This case presented with precocious menerchae, short stature and delayed bone development. These findings are consistent with other reports [2][3][4][5][6] .…”

Section: Discussionsupporting

confidence: 94%

“…In Long standing primary hypothyroidism that is low level of serum T3 and T4 leads to increase TRH secretion which stimulates both TSH and Gonadotropins (FSH & LH) and prolactin from anterior pituitary. High level of TSH acts on the FSH receptors of ovaries causing formation of multicystic ovaries 3 . Here there is iso-sexual precocious puberty, premature menarche, breast development, absent pubic and axillary hair growth and lump in lower abdomen.…”

Section: Introductionmentioning

confidence: 99%

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Van Wyk Grumbach Syndrome-A rare case report

et al. 2015

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“…This case presented with precocious menerchae, short stature and delayed bone development. These findings are consistent with other reports [2][3][4][5][6] .…”

Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Van Wyk Grumbach Syndrome-A rare case report

et al. 2015

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“…It is reasonable to assume the mechanism behind such a possible association is similar to that described by Barnes et al (1973). Any association is likely not to be a common occurrence but professionals in contact with children with Down syndrome who are diagnosed has having a thyroid disorder should be alert to the possibility of other endocrine disorders.…”

Section: Clinical Features Of Thyroid Disorders In Down Syndromementioning

confidence: 96%

“…In girls it can present with breast development, pubic hair, vaginal secretion, menstruation, acceleration of growth and in boys with pubic hair, testis enlargement and height spurt. Barnes et al (1973) studied the association of early puberty with juvenile hypothyroidism in 54 children with primary hypothyroidism (one patient with Down syndrome); and found that 31 of them had evidence of iso-sexual maturation that was advanced when considered in relation to the "maturational" (bone) age. They concluded that long-standing thyroid failure induces increased TSH secretion, both indirectly (through the action of thyrotropin -releasing hormone) and directly (at the level of the pituitary) and this action on pituitary may induce subsequent premature sexual development.…”

Section: Clinical Features Of Thyroid Disorders In Down Syndromementioning

confidence: 99%

Down Syndrome and Thyroid Disorders: A Review

Prasher¹

1999

Downs Syndr. Res. Pract.

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Thyroid disorders are common in the Down syndrome population but many specific areas of importance remain to be resolved. A detailed review of previously published case reports and research studies highlighting the clinical association between Down syndrome and thyroid disorders was undertaken. Historical, epidemiological, immunological, diagnostic and treatment issues are addressed. Recommendations for future management and research are considered.

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“…7,8 The current and most widely accepted theory is that high levels of thyroid-stimulating hormone act on follicle-stimulating hormone receptors because of the molecular similarities between the two hormones. This mechanism, known as "specificity spill over," has been demonstrated in vitro.…”

Section: Practicementioning

confidence: 99%

Acquired primary hypothyroidism: vaginal bleeding in a quiet child

Wormsbecker¹,

Clarson²

2010

Canadian Medical Association Journal

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A girl aged six years, nine months presented with vaginal bleeding, which included clots about 3 cm in diameter. The bleeding had started six days previously, and the patient was using three or four menstrual pads a day. The family had initially attributed the bleeding to an unwitnessed straddle injury, but the child denied it. No other signs of puberty were noted, and there was no history of galactorrhea, dry skin, constipation or intolerance to cold. Initial assessment by a pediatric gynecologist confirmed no evidence of trauma, a foreign body or sexual abuse. A complete blood count and the results of coagulation tests were normal.The parents described the child as having a mild delay in development from infancy, but a formal developmental assessment had not been done. They said she had been quiet and inactive for the past two to three years.An endocrinologist had assessed the girl for obesity when she was 11 months old. At that time her weight was 15.5 kg and length 82.2 cm (both above the 97th percentile). Results of investigations, including the level of serum thyroid-stimulating hormone, were normal, and the obesity was considered exogenous.Family history revealed a maternal aunt with hypothyroidism and morbid obesity, and the mother had men arche when she was 13 years old.On examination, the patient was obese and passive. Her height was 118.5 cm, at the 50th percentile (the mid-parental height was between the 90th and 95th percentiles), and she weighed 33.3 kg (97th percentile) (Figure 1). Her body mass index was 23.9 kg/m 2 (well above the 97th percentile) ( Figure 2), heart rate 76 (normal 90-110) beats/min and blood pressure 82/53 mm Hg (normal for her age). The thyroid gland was not palpable. Breast development on the right was Tanner stage I and on the left stage II (1 cm in diameter breast bud). Results of cardiovascular, respiratory and abdominal examination were normal. There was no axillary hair. External genital examination showed no pubic hair, no enlargement of the clitoris and no estrogenization of the vaginal mucosa. Relaxation of the deep tendon reflexes was delayed.Laboratory investigations confirmed a diagnosis of hypothyroidism. The serum thyroid-stimulating hormone level was markedly elevated, at > 150.0 (range 0.3-5.0) mIU/L, and the serum concentration of free thyroxine was depressed, at 2.4 (range 7.0-23.0) pmol/L. Levels of folliclestimulating (5.0 IU/L) and luteinizing (< 0.1 IU/L) hormone were prepubertal, and the serum 17 β-estradiol was 141 (prepubertal range < 96) pmol/L. The serum prolactin was elevated, at 126 (range 3-29) µg/L. Bone age was five years, nine months (± 17.8 months) at a chronologic age of six years, nine months. Chromosome analysis showed a 46 XX karyotype.Thyroid hormone replacement was started at a dose of 12.5 µg per day with gradual titration, as is standard practice for severe hypothyroidism. The patient had no further vaginal bleeding, and the family reported a substantial improvement in her sociability and level of activity.Within six months after init...

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Sexual Maturation in Juvenile Hypothyroidism

Cited by 14 publications

References 0 publications

Van Wyk Grumbach Syndrome-A rare case report

Van Wyk Grumbach Syndrome-A rare case report

Down Syndrome and Thyroid Disorders: A Review

Acquired primary hypothyroidism: vaginal bleeding in a quiet child

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