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Cullen’s sign and massive ovarian enlargement secondary to primary hypothyroidism in a patient with a normal FSH receptor
  1. A Sultan1,
  2. M R Velaga2,
  3. M Fleet3,
  4. T Cheetham1
  1. 1Department of Paediatrics, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  2. 2Institute of Human Genetics, School of Clinical Medical Sciences, University of Newcastle, UK
  3. 3Department of Paediatric Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to:
    Dr T D Cheetham
    Department of Paediatrics (Children’s Out Patients), Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK; t.d.cheetham{at}


Ovarian hyperstimulation is a recognised complication of longstanding hypothyroidism. A 12 year old girl with atrophic thyroiditis who presented with abdominal pain and distension is reported. She was noted to have bruising in the vicinity of the umbilicus (Cullen’s sign). She had pronounced ovarian enlargement on ultrasonography and it was hypothesised that this profound phenotype might reflect an abnormal FSH receptor. However sequencing of the FSH receptor was normal. The ovarian enlargement resolved with thyroxine replacement. Physicians and surgeons should consider longstanding hypothyroidism in patients presenting with Cullen’s sign.

  • hypothyroidism
  • ovarian hyperstimulation
  • Cullen’s sign
  • FSH receptor

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  • Competing interests: none