JUVENILE HYPOTHYROIDISM WITH PRECOCIOUS SEXUAL DEVELOPMENT

The combination of juvenile hypothyroidism and certain manifestations of precocious sexual development in a -year-old girl is reported. When first examined, at the age of years, urinary gonadotropin was elevated to adult levels and 30 per cent of the cells in the vaginal smear were of the cornified squamous variety. Biopsy of enlarged cystic ovaries disclosed findings similar to those in the ovaries of adults with the Stein-Leventhal syndrome or in response to administration of gonadotropin. The patient became euthyroid during treatment with desiccated thyroid. Although periodic vaginal bleeding then ceased and the vaginal smear no longer contained cornified squamous cells, the enlarged nipples did not regress and increased excretion of urinary gonadotropin continued.