Case report of a 7-year-old girl with autoimmune hypothyroidism and precocious puberty, suggesting endocrine evaluation is crucial.
Immune-mediated destruction of two or more endocrine glands results in a cluster of deficits in multiple glands, known as autoimmune polyglandular syndrome. Autoimmune hypothyroidism is a common presentation of autoimmune polyglandular syndrome type II (APS–II). Long-standing, untreated hypothyroidism may cause isosexual precocious puberty, which is termed Van Wyk Grumbach syndrome. A 7-year-old girl was diagnosed with autoimmune hypothyroidism and type 1A diabetes mellitus and hence termed as autoimmune polyglandular syndrome type II. She had a history of menarche at the age of 2 years and 6 months and presented with bilateral ovarian cysts and delayed bone age. She was treated with thyroxine along with insulin. Thyroxine therapy stopped her menstruation with a reduction of ovarian cyst size. J Assoc Clin Endocrinol Diabetol Bangladesh, July 2025;4(2): 90-95
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Asefeen et al. (2025) studied this question.
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