title: Primary hypothyroidism presenting as severe vaginal bleeding in a prepubertal girl.
abstract: We describe a case of acquired primary hypothyroidism in a prepubertal girl who presented with profound bradycardia, precocious puberty, and severe vaginal bleeding. A pelvic ultrasound revealed markedly enlarged ovaries with numerous cysts. Cystic aspiration, in concert with L-thyroxine therapy, appeared to halt vaginal bleeding, and led to resolution of cysts. This is the first reported case of percutaneous cyst aspiration to treat ovarian hyperstimulation caused by hypothyroidism in a child.
authors.affiliation: Department of Surgery, Children's Hospital Boston, Massachusetts 02115, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Gordon
authors.forename: D J
authors.initials: DJ
authors.lastname: Austin
authors.forename: S
authors.initials: S
authors.lastname: Radovick
authors.forename: M R
authors.initials: MR
authors.lastname: Laufer
mesh_terms: D001919:Bradycardia / Q000209:etiology; D002648:Child; D003937:Diagnosis, Differential; D004322:Drainage; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology; D011388:Prolactin / Q000097:blood; D011629:Puberty, Precocious / Q000209:etiology*; D013967:Thyroiditis, Autoimmune / Q000150:complications; D013974:Thyroxine / Q000627:therapeutic use; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology*
chemical_list: D004958:Estradiol; D011388:Prolactin; D013974:Thyroxine