Mayer-Rokitansky-Küster-Hauser Syndrome Associated With Diabetes Mellitus and Renal Anomalies in an Adolescent Girl: A Rare Case Report

<h2>Abstract</h2><h3>Background/Objective</h3> Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome is a rare congenital anomaly characterized by agenesis or hypoplasia of the uterus and upper vagina in phenotypically normal females. Although patients with MRKH syndrome typically exhibit normal secondary sexual development, associations with extragenital anomalies and metabolic conditions such as diabetes mellitus have been increasingly reported. <h3>Case Description</h3> A female patient initially presented at the age of 15 [currently 19 years old] with primary amenorrhea and absence of secondary sexual characteristics. Initial laboratory evaluation showed elevated follicle-stimulating hormone [FSH] and thyroid-stimulating hormone [TSH] levels, while thyroid antibodies and prolactin were within normal limits. Pelvic magnetic resonance imaging [MRI] revealed poorly visualized ovaries, a hypoplastic or absent uterus and upper vagina, and urinary tract anomalies including a duplicated right ureter. One year later, she developed symptoms suggestive of diabetes mellitus and was found to have elevated random and fasting blood glucose levels. Her mother had been diagnosed with type 2 diabetes mellitus prior to conception. The patient was referred to endocrinology to evaluate the possibility of monogenic diabetes [MODY]. The constellation of uterovaginal aplasia, renal anomalies, and endocrine dysfunction raises clinical suspicion of an expanded phenotypic spectrum or a potential overlap syndrome, such as MURCS. [Reference ranges: FSH 3–10 mIU/mL in follicular phase; TSH 0.4–4.0 μIU/mL]. <h3>Conclusion</h3> This case highlights the importance of comprehensive systemic evaluation in patients with MRKH syndrome, especially when extragenital anomalies or metabolic abnormalities such as diabetes mellitus coexist. Early recognition and multidisciplinary management are essential for optimal care and may provide valuable insights into potentially shared developmental and genetic pathways.