Elevated α-fetoprotein levels in van Wyk-Grumbach syndrome: A case report and review of literature

Nivedita Patni, Luisa F. Cervantes, Alejandro Diaz

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


The association between primary hypothyroidism and precocious puberty secondary to ovarian hyperstimulation has been recognized for over a century. Here, we report the case of a 9-year-old girl with severe primary hypothyroidism, who presented with premature menarche, enlarged pituitary gland, enlarged ovaries with multiple cysts, and elevated prolactin and α-feto protein levels. Pituitary and ovarian radiology findings, and α-feto protein levels normalized a few weeks after hypothyroidism treatment was started. Reviewing the literature we found several reports of increased levels of tumor markers in girls with this association. Thyroid function tests should be always part of the evaluation of patients with precocious puberty especially if the bone age is delayed. Tumor markers and liver function tests may be abnormal in patients with severe hypothyroidism and improve soon after thyroid hormone replacement is started.

Original languageEnglish (US)
Pages (from-to)761-767
Number of pages7
JournalJournal of Pediatric Endocrinology and Metabolism
Issue number7-8
StatePublished - Aug 2012


  • Hypothyroidism
  • Ovarian hyperstimulation
  • Precocious puberty
  • α-feto protein

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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