An 11-year-old girl with a personal history of subclinical hypothyroidism treated with levothyroxine and transient alopecia was referred to the Emergency Department by her previous Primary Care paediatrician due to a non-significant increase in lip size.
There is no pain or itching.
She has not yet presented menarche or referred abnormal vaginal discharge.
The general physical examination was normal.
As for the exploration of the genital area, the only finding was hypertrophy of both lower lips without hypertrophy of the associated clitoris.
Pathway development according to Tanner stage II (A1S2P2).
1.
The patient was referred to the Pediatric Endocrinology Department of our hospital, where the following complementary examinations were requested:
• Determination of sex hormones (testosterone and estradiol), as well as adrenal steroids (LH and FSH) (17-hydroxyprogesterone and S-DHEA).
None of these determinations showed pathological results.
• Radiography of the wrist, which showed a bone age according to the chronological age of the patient.
• Thyroid function study: no pathological findings.
In view of the results of the diagnostic tests, the patient was diagnosed with bilateral hypertrophy of the lower lips of constitutional origin.
