Treating Severe Primary Hypothyroidism: Turning Growth Failure Into Rapidly Progressive Puberty

Growth failure and precocious or rapidly progressive puberty have been documented in several instances of untreated overt primary hypothyroidism. However, the sequential occurrence of these conditions within the same patient is less frequently observed. In this report, we present a case wherein growth failure, followed by rapidly progressive puberty, manifested following thyroxine replacement therapy. Notably, the etiology of the puberty onset in this case was centrally derived, distinguishing it from the more commonly reported Van Wyk-Grumbach syndrome. This case report provides a comprehensive summary of the aforementioned case, conducts a thorough review of relevant literature, and proposes a plausible mechanistic explanation for the observed association with gonadotropin-inhibiting hormones. The significance of maintaining vigilant thyroid function screening to detect non-specific or atypical presentations of hypothyroidism is also underscored.