This case shows the characteristic features and hormonal profile seen in Van Wyk-Grumbach syndrome:

• hypothyroidism with a very high TSH level
• precocious puberty 
• delayed bone age

The Van Wyk-Grumbach syndrome is considered as the only entity in which precocious puberty is associated with a delayed bone age.

Additional contributors: R. Bouguelaa, MD, ZE.Boudiaf, MD.