title: Asymmetrical Ovarian Enlargement: Caught Timely Before the Cut!
abstract: BACKGROUND
  Van Wyk-Grumbach syndrome is a rare complication of prolonged untreated primary hypothyroidism characterized by precocious puberty and enlarged multicystic ovaries. High index of suspicion and timely diagnosis can prevent unnecessary surgical procedures because this condition can be reversed with thyroid hormone supplementation.
  
  
  METHODS
  A 12-year-old girl underwent abdominal ultrasonography for recurrent abdominal pain, which showed bilateral asymmetrical enlargement of ovaries. Ovarian tumor markers were negative. Subsequent evaluation revealed severe hypothyroidism. Patient was started on levothyroxine and both ovaries showed regression to normal volume within 1 year of normalizing thyroid function tests.
  
  
  CONCLUSIONS
  Prompt and adequate medical management with levothyroxine can completely reverse ovarian enlargement associated with hypothyroidism.
authors.affiliation: Department of Endocrinology, B.Y.L. Nair Charitable Hospital and Topiwala National Medical College, Mumbai Central, Mumbai, India. Electronic address: bhagwatnik@yahoo.co.in.
authors.forename: Nikhil M
authors.initials: NM
authors.lastname: Bhagwat
authors.affiliation: Department of Endocrinology, B.Y.L. Nair Charitable Hospital and Topiwala National Medical College, Mumbai Central, Mumbai, India.
authors.forename: Pradip P
authors.initials: PP
authors.lastname: Dalwadi
authors.affiliation: Department of Endocrinology, B.Y.L. Nair Charitable Hospital and Topiwala National Medical College, Mumbai Central, Mumbai, India.
authors.forename: Ameya S
authors.initials: AS
authors.lastname: Joshi
authors.affiliation: Department of Endocrinology, B.Y.L. Nair Charitable Hospital and Topiwala National Medical College, Mumbai Central, Mumbai, India.
authors.forename: Pratibha S
authors.initials: PS
authors.lastname: Pawal
authors.affiliation: Department of Endocrinology, B.Y.L. Nair Charitable Hospital and Topiwala National Medical College, Mumbai Central, Mumbai, India.
authors.forename: Premlata K
authors.initials: PK
authors.lastname: Varthakavi
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D002648:Child; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D010048:Ovarian Cysts / Q000209:etiology*; D011629:Puberty, Precocious / Q000209:etiology*; D013577:Syndrome; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D013974:Thyroxine
keywords: Hypothyroidism; Ovarian enlargement; Van Wyk Graumbach Syndrome