Ogawa Eishin, Isojima Tsuyoshi, Sato Yasuhiro, Motoyama Kahoko, Kodama Hiroko
Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan.
Department of Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan.
Clin Pediatr Endocrinol. 2018;27(3):165-169. doi: 10.1297/cpe.27.165. Epub 2018 Jul 31.
We describe the case of a girl diagnosed with Graves' disease (GD) at 2 yr of age, who developed early puberty. Preoperative examination for craniosynostosis revealed thyrotoxicosis. While she was tall and her bone age was advanced at GD onset, her linear growth attenuated after commencement of anti-thyroid treatment. However, at approximately 6 yr of age, breast budding was recognized. Hormonal analysis revealed pubertal levels of LH response to a GnRH stimulation test and serum E2. Gonadal suppression therapy with GnRH agonist was initiated, and her adult stature slightly exceeded the genetic potential. Although accelerated growth and skeletal maturation are often reported to occur at GD onset in prepubertal patients, early puberty is unusual, and this is the first reported case of sexual precocity in a girl with GD.
我们描述了一名2岁时被诊断为格雷夫斯病（GD）的女孩的病例，她出现了性早熟。因颅缝早闭进行的术前检查发现了甲状腺毒症。虽然她在GD发病时身材高大且骨龄提前，但在开始抗甲状腺治疗后，她的线性生长减缓。然而，在大约6岁时，发现了乳房发育。激素分析显示，促性腺激素释放激素（GnRH）刺激试验中促黄体生成素（LH）的反应以及血清雌二醇（E2）达到了青春期水平。开始使用GnRH激动剂进行性腺抑制治疗，她的成年身高略超过遗传潜力。虽然在青春期前的GD患者中，发病时通常会报告生长加速和骨骼成熟，但性早熟并不常见，这是首例报道的患有GD的女孩性早熟病例。
