Hyperthyroidism in McCune-Albright Syndrome - a case report

J Pediatr Endocrinol Metab. 2022 Nov 10;36(3):319-322. doi: 10.1515/jpem-2022-0357. Print 2023 Mar 28.

Abstract

Objectives: We intend to describe a case of McCune-Albright Syndrome (MAS), a rare disease characterized by fibrous dysplasia (FD), cutaneous hyperpigmentation and hyperfunctioning endocrinopathies (HFE).

Case presentation: We report the case of a 13-year-old male child who presented with a café-au-lait macule in the lumbosacral region and disabling polyostotic FD, requiring several surgical interventions and bisphosphonates from the age of 3 years (Y) + 9 months (M) due to persistent and severe pain. Hyperthyroidism (HT) became apparent at 5 Y + 1 M with a T3/T4 ratio greater than 20. Treatment with anti-thyroid drugs (ATD) was carried out for 7 Y and there was a progressive improvement in pain complaints 8 M after starting ATD, allowing treatment with pamidronate to be discontinued. Total thyroidectomy was performed at 12 Y + 5 M.

Conclusions: This is a case of MAS-associated HT that reflects the deleterious effect of thyroid hormone excess on FD, reinforcing the need of having a low threshold for suspicion of HFE that may arise.

Keywords: McCune-albright syndrome; hyperfunctioning endocrinopathies; hyperthyroidism; polyostotic fibrous dysplasia.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Diphosphonates
  • Endocrine System Diseases* / complications
  • Fibrous Dysplasia, Polyostotic* / complications
  • Fibrous Dysplasia, Polyostotic* / therapy
  • Hormones
  • Humans
  • Hyperthyroidism* / etiology
  • Male

Substances

  • Hormones
  • Diphosphonates