8.5岁女孩性早熟伴原发性甲状腺功能减退的不寻常表现

S. Rikta, F. Ashraf, Samira Areen
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引用次数: 0

摘要

早熟是儿童时期的妇科问题之一。患有甲状腺功能减退症的儿童通常青春期发育迟缓。但原发性甲状腺功能减退是性早熟的罕见原因之一,尤其是在长期未经治疗的患者中。多发性囊性卵巢引起的双侧卵巢增大是原发性甲状腺功能减退症的罕见并发症。卵巢增大根本不需要治疗。这是一例8.5岁女孩的病例报告,她在周边医院被诊断为性早熟伴良性卵巢肿瘤,正准备接受剖腹手术。当患者在孟加拉国达卡Shaheed Suhravardy医学院医院(ShSMCH)入院时,经过彻底调查,诊断为原发性甲状腺功能减退症。她接受了甲状腺素替代治疗,并通过每月进行子宫和附件的USG、甲状腺功能测试进行密切监测。2个月后的USG显示卵巢体积显著减少,6个月时卵巢体积降至正常。还注意到,卵巢体积的减少率对应于每隔2个月连续测量的血清TSH水平的减少率。德尔塔医学杂志2018年1月6(2):102-105
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Unusual Presentation of Precocious Puberty Associated with Primary Hypothyroidism in a 8.5 Years Old Girl
Precocious puberty is one of the gynaecological problems in childhood. Children with hypothyroidism generally have delayed pubertal development. But primary hypothyroidism is one of the rare causes of precocious puberty especially in long standing untreated patients. Bilateral ovarian enlargement due to multiple cystic ovaries is a rare complication of primary hypothyroidism. For ovarian enlargement no treatment is required at all. This is a case report of an 8.5 years old girl diagnosed as a case of precocious puberty with benign ovarian tumour at a peripheral hospital and was being prepared to undergo laparotomy. When patient was admitted at Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka, Bangladesh, after thorough investigations primary hypothyroidism was diagnosed. She was given thyroxin replacement and close monitoring was done by doing USG of uterus and adnexae, thyroid function test at monthly interval. USG after 2 months revealed significant reduction of ovarian volume and at 6 month ovarian volume reduced to normal. It was also noticed that the rate of reduction of ovarian volume corresponds to the rate of reduction of serum TSH level measured serially at every 2 months interval.Delta Med Col J. Jan 2018 6(2): 102-105
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