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Concurrent occurrence of chronic lymphocytic thyroiditis with hypothyroidism and growth hormone deficiency in a Turner's syndrome patient.

BACKGROUND
Concurrent deficiencies of three hormones in patients with Turner's syndrome (TS) have rarely been reported. Here, we describe a case of a young girl who had Turner's syndrome with concomitant chronic lymphocytic thyroiditis, growth hormone deficiency, and hypothyroidism with cardiopericarditis.


CASE
An 11-year-old girl was referred to the outpatient clinic because of short stature, ochriasis, and cardiopalmus. Her ultrasound revealed absence of ovarian tissue. Karyotype examination suggested Turner's syndrome with sex hormone deficiency. She was found to have an abnormal thyroid gland and elevated thyroid stimulating hormone (TSH). A positive thyroid autoantibody titer confirmed the diagnosis of chronic lymphocytic thyroiditis with hypothyroidism. Furthermore, her growth hormone levels were well below normal.


DIAGNOSIS
A multi-endocrine disorder, i.e., Turner's syndrome with chronic lymphocytic thyroiditis, growth hormone deficiency, and hypothyroidism with cardiopericarditis was diagnosed. Growth hormone and thyroxin substitution therapy was suggested.