ECE2016 Eposter Presentations Clinical case reports - Thyroid/Others (71 abstracts)
Hypothyroidism as a cause of precocious puberty
Mikele Torino Paletti 1 , Angela Cristina Menegato Miranda 1 , Bruna Lopes Sanseverino 1 , Eliane Lopes Miranda Cosson 1 , Fabiana Sayuri Takahashi 1 , Flavia Renata de Sousa Caldeira 1 , Leonardo César Simões Faria 1 , Martin Andres Amicone 1 , Nícia Das Mercês Maia Aguiar 1 , Tânia Mara Pinheiro Alves Souza 1 , Thatiani Coelho Placco Codonho 1 , Hesio José de Mora dos Anjos 1 , Julimar Benedita Gomes Oliveira 1 , Odon Paes Barbosa Junior 1 , Francilene Silva 1 , Ana Luisa de Jesus 1 , Denise Rosso Tenorio Wanderley Rocha 1 & Alberto Krayyem Arbex 1,
1IPEMED Medical School, Sao Paulo, Brazil; 2Fiocruz Brazil – Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil.
Introduction: Hypothyroidism is a rare cause of early puberty in childhood. It reduces the growth rate by decreasing the amplitude of GH pulses. We report the case of a child who developed precocious puberty and reduced speed consequent to hypothyroidism growth. The treatment of thyroid disease with levothyroxine led to regression of pubertal development and resumption of growth.
Methods: A.J.S., female, 1 year and 5 months of age at first consultation. She to came the endocrinology service in March 2011, complaining about bilateral breast enlargement since birth. Her mother reported pregnancy without complications. Cesarean delivery, birth weight and height were 48 cm and 3.3 kg, respectively. Breast feeding up to 10 months; no use of medications. Physical examination in 2011 showed Tanner M2 P1, genitals and thyroid gland without changes on physical examination, 11 kg weight and 80 cm in height (50–75 percentile).
Results: In 2011, TSH was 7.48 U/l, LH: <0.71 U/l, FSH: 4.1 U/l, Estradiol: 15 U/l. Breast ultrasound showed stromal gland stimulation. Pelvic US showed no change. Bone age was 18 months to 2 years. The conduct was to prescribe levothyroxine 50 μg/day. When she became 2 years and 6 months old she had a Tanner M2P2. TSH: 1.69 U/l, Free T4: 33.6 U/l. Growth rate of 11.5 cm/year. She came back in January 2013, with Tanner M2P2. On April 2014: Weight: 17.6 kg and Height: 105 cm, Tanner M2P1. Bone age: 2 years old. Growth rate 04/2014 to 04/2015: 8.5 cm/year, the patient was euthyroid. January 2016 she was asymptomatic, in use of levothyroxine 75 μg/day, Tanner: M2P1, Height: 116 cm, Weight: 23.8 kg.
Discussion: Treatment of the thyroid disease led to regression of the pubertal development and reduction of growth velocity as a consequence of primary hypothyroidism. Thyroid dysfunction may be associated with Precocious puberty in the clinical practice, demanding a specific clinical approach.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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