Pediatric Psoriasis Associated with Van Wyk Grumbach Syndrome: A case report

##plugins.themes.academic_pro.article.sidebar##

Published Nov 18, 2023
Download
pdf
Vol. 101 No. 10 (2023): Tunis med oct 2023

##plugins.themes.academic_pro.article.main##

Asma Marzouk
Departement of Pediatrics and Neonatology , Yasminette hospital, Ben Arous/ Faculty of Medecine of Tunis, University Tunis El Manar,Tunis, Tunisia
Rania Mezzi
Department of Pediatrics and Neonatology, Yasminette hospital ,Ben Arous / Faculty of Medecine of Tunis, University Tunis El Manar, Tunis, Tunisia
Saida Zelfani
Faculty of Medecine of Tunis,University El Manar, Tunis, Tunisia
Nour Jelalia
Department of Pediatrics and Neonatology, Yasminette hospital ,Ben Arous / Faculty of Medecine of Tunis, University Tunis El Manar, Tunis, Tunisia
Saad Ayeb
Department of Pediatrics and Neonatology, Yasminette hospital, Ben Arous/ Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Asma Bouaziz
Department of Pediatrics and Neonatology, Yasminette hospital, Ben Arous/ Faculty of Medecine of Tunis, University of Tunis El Manar, Tunis, Tunisia

Abstract

Introduction: Psoriasis is a common chronic inflammatory condition, often beginning in childhood in approximately one-third of cases. It can be associated with various other autoimmune diseases such as rheumatoid arthritis, celiac disease, and thyroid disorders. However, its co-occurrence with Van Wyk Grumbach syndrome has not been described in the pediatric population. This syndrome, resulting from untreated hypothyroidism, is characterized by early puberty and ovarian cysts.
Observation: A 15-year-old adolescent with a diagnosis of psoriasis since the age of 9 presented with chronic constipation and headaches. She exhibited early puberty (menarche at 9 years) and academic regression. Clinical examination revealed growth retardation and arterial hypertension. Hormonal analyses revealed primary hypothyroidism : Free Thyroxine (FT4)=7pmol/mL(9- 20 pmol/l), Thyroid Stimulating Hormone (TSH)=200 mIU/mL( 0,4 - 5 mUI/ml.). The ultrasound and scintigraphic appearance were suggestive of thyroiditis. Additionally, she experienced menstrual irregularities and pelvic pain. Radiological exploration revealed a left ovarian cyst. The diagnosis of Van Wyk Grumbach syndrome was established due to early puberty, hypothyroidism, and polycystic ovary. Treatment with l-thyroxine led to stabilization of blood pressure and hormonal levels. Her height remained below the target adult height.
Conclusion: Assessment of thyroid function appears necessary in pediatric patients with psoriasis. Early hormonal replacement therapy for hypothyroidism may alleviate the symptoms of Van Wyk Grumbach syndrome and mitigate its impact on stature.

Keywords:

psoriasis , child, early puberty, hypothyroidism, polycystic ovary

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Ammar M, Zaraa I, Bouchleka Souissi C, Dhaoui A, Doss N, Ben Osman A, et al. [Familial psoriasis: descriptive report of 9 families]. Tunis Med. nov 2009;87(11):750‑4.
  2. Bronckers IMGJ, Paller AS, van Geel MJ, van de Kerkhof PCM, Seyger MMB. Psoriasis in Children and Adolescents: Diagnosis, Management and Comorbidities. Paediatr Drugs. oct 2015;17(5):373‑84.
  3. Kittler NW, Cordoro KM. Pediatric Psoriasis Comorbidities. Skin Ther Lett. nov 2020;25(5):1‑6.
  4. Eapi S, Chowdhury R, Lawal OS, Mathur N, Malik BH. Etiological Association Between Psoriasis and Thyroid Diseases. Cureus. 12 janv 2021;13(1):e12653.
  5. Kusuma Boddu S, Ayyavoo A, Hebbal Nagarajappa V, Kalenahalli KV, Muruda S, Palany R. Van Wyk Grumbach Syndrome and Ovarian Hyperstimulation in Juvenile Primary Hypothyroidism: Lessons From a 30-Case Cohort. J Endocr Soc. 5 mai 2023;7(6):bvad042.
  6. Kandasamy D, Malik R, Sharma R, Jana M. Case 308: Van Wyk-Grumbach Syndrome. Radiology. déc 2022;305(3):746‑50.
  7. Chabchoub I, Litaiem N, Gara S, Jaber K, Dhaoui MA, Zeglaoui F. Assessing the validity and interpretability of the Simplified Psoriasis Index in Tunisian patients. Tunis Med. janv 2022;100(1):49‑55.
  8. Reddy P, Tiwari K, Kulkarni A, Parikh K, Khubchandani R. Van Wyk Grumbach Syndrome: A Rare Consequence of Hypothyroidism. Indian J Pediatr. nov 2018;85(11):1028‑30.
  9. Zghal A, Zeglaoui F, Kallel L, Karmous R, Ben Ammar H, Labbane R, et al. [Quality of life in dermatology: Tunisian version of the Skindex-29]. Tunis Med. janv 2003;81(1):34‑7.
  10. Imaouen M, Boufaida N, Salhi H, El Ouahabi H. Association des atteintes cutanées auto-immunes et thyroïdite d’Hashimoto : à propos de 15 cas. Ann Endocrinol. 1 sept 2018;79(4):363.
  11. Cira CI, Carsote M, Nistor C, Petca A, Petca RC, Sandru F. Conundrum for Psoriasis and Thyroid Involvement. Int J Mol Sci. 3 mars 2023;24(5):4894.
  12. Ruffilli I, Ragusa F, Benvenga S, Vita R, Antonelli A, Fallahi P, et al. Psoriasis, Psoriatic Arthritis, and Thyroid Autoimmunity. Front Endocrinol. 2017;8:139.
  13. Vastarella M, Megna M, Lupoli GA, Napolitano M, Gallo L, Balato A, et al. Is there any association between psoriasis, psoriatic arthritis and thyroid autoimmunity? Australas J Dermatol. mai 2021;62(2):e207‑11.
  14. Waddankeri S, Waddankeri M, Waddankeri S, Arora K. The Clinical Septet of Van Wyk-Grumbach Syndrome: A Case Series from a Tertiary Care Centre in Kalyana Karnataka, India. touchREV Endocrinol. 2023 May;19(1):98-102.