Autoimmune Thyroid Syndrome in Women With Turner’s Syndrome—The Association With Karyotype

Abstract

Autoimmune thyroid disease develops at an unexpectedly high rate in females with Turner syndrome (TS), but studies of the effect of karyotype on thyroid autoimmunity in adults with TS have given mixed results. This study reviewed the records of 152 women with karyotypically confirmed TS who attended adult Turner clinics. Data were available for 145 females ranging in age from 16 to 52 years (average, 26 years). Sixty of these 145 women (41%) had positive tests for antimicrosomal and/or anti-thyroglobulin antibodies. Both types of antibody were found in 24 instances. Twenty-two women, 15% of the total, had hypothyroidism (subclinical in eight), and one had Graves' disease. Thyroid autoantibodies were found in 83% of women with an isochromosome-X karyotype, 41% of those with a 45X karyotype, and 14 with other karyotypes. Hypothyroidism was present in 37.5% of women with the isochromosome-X karyotype and 14% of those with 45X. There was no indication that other immune-mediated conditions were significantly more prevalent in those with thyroid autoimmunity. Autoimmune thyroid dysfunction was common in these women with TS, especially those with the isochromosome-X karyotype. The authors believe that thyroid autoantibodies and thyrotropin levels should be estimated each year from age 10 in all females with TS. Once thyroid autoantibodies appear, only annual thyrotropin values are needed. Hypothyroidism should be promptly treated to permit maximum growth in adolescence and to avoid obesity and hypercholesterolemia.