Turner's syndrome with concomitant hypopituitarism

The unique case of a young woman with concomitant pituitary insufficiency a nd gonadal dysgenesis due to Turner's syndrome is described. At the age of 17 years, when first examined elsewhere, this patient mas prepubertal and s hort and a diagnosis of growth hormone deficiency was made. One year later, while on growth hormone (GH) substitution, thyrotrophin deficiency and hyp ogonadotrophic hypogonadism were confirmed and thyrosine and sex steroid su bstitution therapy was initiated. Upon evaluation in our clinic, at the age of 30 years, the low final height achieved with the GH substitution therap y, a number of clinical characteristics and the absence of ovarian tissue o n ultrasound led to examination of the patient's karyotype, which revealed concurrent gonadal dysgenesis due to Turner's syndrome. This case illustrat es that the co-existence of primary and secondary hypogonadism may obscure and delay the diagnosis of Turner's syndrome a diagnosis which alters the c ounselling of the patient from the productive perspective.