Author(s): Abdulkarim A. Al-Rabiaah
A 6 year old girl with Down’s syndrome presented with cyclic vaginal bleeding, without other sings of sexual precocity, and bilateral ovarian cysts. Endocrine investigations indicated severe autoimmune hypothyroidism. Basal luteinizing hormone (LH) was suppressed and follicular stimulating hormone (FSH) was high, with high serum estradiol level and blunted response to GnRH test.