title: Association of Van Wyk Grumbach and Debre Semelaigne Syndromes with Severe Hypothyroidism.
abstract: BACKGROUND
  Van Wyk Grumbach syndrome (VWGS) and Kocher-Debre Semelaigne syndrome (KDSS) are rare forms of pseudo-precocious puberty and myopathy in patients with longstanding untreated hypothyroidism. We present the case of an adolescent girl who developed pseudo-precocious puberty and myopathy caused by long-term untreated hypothyroidism.
  
  
  METHODS
  A 17-year-old female patient was referred to our outpatient clinic due to menstrual irregularities. She had muscle pain and multiple cystic ovaries in addition to clinical signs of severe congenital hypothyroidism. High levels of creatinine and creatinine kinase and accompanying muscle hypertrophy were present. After the initiation of L-thyroxine therapy, the symptoms were alleviated in a short time.
  
  
  CONCLUSIONS
  Congenital and acquired hypothyroidism should be considered in the differential diagnosis of pseudo-precocious puberty and myopathy that presents with muscle pain, muscle hypertrophy, and elevated creatinine kinase levels.
authors.affiliation: Ankara Children's Hematology and Oncology Training Hospital, Department of Pediatrics, Ankara, Turkey. Electronic address: alkimakman@gmail.com.
authors.forename: Alkim
authors.initials: A
authors.lastname: Oden Akman
authors.affiliation: Ankara Children's Hematology and Oncology Training Hospital, Department of Pediatric Endocrinology, Ankara, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Tayfun
authors.affiliation: Yıldırım Beyazıt University, Medical School, Department of Pediatrics, and Ankara Children's Hematology and Oncology Training Hospital, Department of Pediatric Endocrinology, Ankara, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Demirel
authors.affiliation: Ankara Children's Hematology and Oncology Training Hospital, Department of Pediatric Endocrinology, Ankara, Turkey.
authors.forename: Seyit Ahmed
authors.initials: SA
authors.lastname: Ucakturk
authors.affiliation: Ankara Children's Hematology and Oncology Training Hospital, Department of Pediatrics, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Gungor
mesh_terms: D000293:Adolescent; D003409:Congenital Hypothyroidism / Q000150:complications* / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications*; D018482:Muscle, Skeletal / Q000473:pathology*; D009135:Muscular Diseases / Q000150:complications* / Q000209:etiology; D010048:Ovarian Cysts / Q000175:diagnosis; D011629:Puberty, Precocious / Q000175:diagnosis* / Q000209:etiology; D013974:Thyroxine / Q000627:therapeutic use
chemical_list: D013974:Thyroxine
keywords: Hypothyroidism; Myopathy; Pseudo-precocious puberty