title: Cullen's sign and massive ovarian enlargement secondary to primary hypothyroidism in a patient with a normal FSH receptor.
abstract: Ovarian hyperstimulation is a recognised complication of longstanding hypothyroidism. A 12 year old girl with atrophic thyroiditis who presented with abdominal pain and distension is reported. She was noted to have bruising in the vicinity of the umbilicus (Cullen's sign). She had pronounced ovarian enlargement on ultrasonography and it was hypothesised that this profound phenotype might reflect an abnormal FSH receptor. However sequencing of the FSH receptor was normal. The ovarian enlargement resolved with thyroxine replacement. Physicians and surgeons should consider longstanding hypothyroidism in patients presenting with Cullen's sign.
authors.affiliation: Department of Paediatrics, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: A
authors.initials: A
authors.lastname: Sultan
authors.forename: M R
authors.initials: MR
authors.lastname: Velaga
authors.forename: M
authors.initials: M
authors.lastname: Fleet
authors.forename: T
authors.initials: T
authors.lastname: Cheetham
mesh_terms: D000293:Adolescent; D003937:Diagnosis, Differential; D004438:Ecchymosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000000981:diagnostic imaging; D016471:Ovarian Hyperstimulation Syndrome / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism; D010053:Ovary / Q000000981:diagnostic imaging; D011629:Puberty, Precocious / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D011962:Receptors, FSH / Q000235:genetics* / Q000378:metabolism; D017422:Sequence Analysis, DNA; D013997:Time Factors; D014463:Ultrasonography; D014472:Umbilicus
chemical_list: D011962:Receptors, FSH; D005640:Follicle Stimulating Hormone