Kumble, AliPhadke, Abhishek KSiriac, AncilineKhubsad, Payal2025-10-122025-10-122025https://hdl.handle.net/20.500.14572/2597Ali Kumble Head of the Department,All from Department of Paediatrics, Indiana Hospital and Heart Institute, Pumpwell, Mangaluru, Karnataka 575002, India . Abhishek K Phadke Senior Consultant,All from Department of Paediatrics, Indiana Hospital and Heart Institute, Pumpwell, Mangaluru, Karnataka 575002, India . Anciline Siriac DNB Resident,All from Department of Paediatrics, Indiana Hospital and Heart Institute, Pumpwell, Mangaluru, Karnataka 575002, India . Payal Khubsad Consultant Endocrinologist, All from Department of Paediatrics, Indiana Hospital and Heart Institute, Pumpwell, Mangaluru, Karnataka 575002, India .Abstract: Van Wyk and Grumbach syndrome (VWGS) is a rare condition characterized by a triad of juvenile hypothyroidism, precocious puberty, and ovarian enlargement with multiple cysts. Here is a case of a 7-year-old female child presented with vaginal bleeding without breast or pubic hair development. On examination she had short stature. Family history of acquired hypothyroidism was present in both parents. Laboratory tests confirmed severe hypothyroidism with TSH levels >100 mIU/mL. Ultrasound revealed an enlarged uterus with fluid-filled internal echoes and polycystic ovaries. Thyroxine therapy was initiated and titrated, resulting in cessation of bleeding within 3 days.en-USHypothyroidismPrecocious pubertyOvarian cystArticle