Patni Nivedita, Cervantes Luisa F, Diaz Alejandro
Department of Pediatric Endocrinology, Miami Children's Hospital, 3100 SW, 62nd Avenue, Miami, FL 33155, USA.
J Pediatr Endocrinol Metab. 2012;25(7-8):761-7. doi: 10.1515/jpem-2012-0112.
The association between primary hypothyroidism and precocious puberty secondary to ovarian hyperstimulation has been recognized for over a century. Here, we report the case of a 9-year-old girl with severe primary hypothyroidism, who presented with premature menarche, enlarged pituitary gland, enlarged ovaries with multiple cysts, and elevated prolactin and alpha-feto protein levels. Pituitary and ovarian radiology findings, and alpha-feto protein levels normalized a few weeks after hypothyroidism treatment was started. Reviewing the literature we found several reports of increased levels of tumor markers in girls with this association. Thyroid function tests should be always part of the evaluation of patients with precocious puberty especially if the bone age is delayed. Tumor markers and liver function tests may be abnormal in patients with severe hypothyroidism and improve soon after thyroid hormone replacement is started.
原发性甲状腺功能减退与卵巢过度刺激继发的性早熟之间的关联已被认识超过一个世纪。在此，我们报告一例9岁严重原发性甲状腺功能减退女孩的病例，该女孩出现初潮过早、垂体增大、卵巢增大伴多个囊肿，以及催乳素和甲胎蛋白水平升高。在开始甲状腺功能减退治疗几周后，垂体和卵巢的放射学检查结果以及甲胎蛋白水平恢复正常。回顾文献，我们发现了几篇关于患有这种关联的女孩肿瘤标志物水平升高的报道。甲状腺功能检查应始终作为性早熟患者评估的一部分，尤其是在骨龄延迟的情况下。严重甲状腺功能减退患者的肿瘤标志物和肝功能检查可能异常，在开始甲状腺激素替代治疗后很快会改善。
