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November 27, 1981

Association of Graves' Disease With Turner's Syndrome

JAMA. 1981;246(21):2429. doi:10.1001/jama.1981.03320210011004

To the Editor.—  An increased incidence of thyroid autoantibodies is known to occur in patients with Turner's syndrome.1,2 The disorders closely related to thyroid autoantibodies are Hashimoto's disease and Graves' disease. A striking association of Hashimoto's disease with Turner's syndrome, especially due to structural variations of an X chromosome, has been repeatedly shown.1-4 Yet, Graves' disease has rarely been documented in patients with this chromosomal abnormality.4

Report of a Case.—  When this woman was born, a karyotype of 45,XO (Turner's syndrome) was determined during the investigation of bilateral pedal edema. The physical findings included hypertelorism, slight cubitus valgus, and a widely spaced nipple. A webbed neck, a low hairline, and multiple, pigmented nevi were absent. At age 11 years, because of the absence of secondary sex characteristics, she was given a conjugated estrogen preparation for two years, followed by the addition of medroxyprogesterone for the onset of