Sir.—We read with great interest the article entitled "Multicystic Ovaries Detected by Sonography in Children with Hypothyroidism," by Linsay et al (Journal 1980;134:588-592).
We recently described the case of a 34-month-old girl with congenital hypothyroidism who exhibited precocious puberty manifested by breast development with secretion of a whitish fluid, recurrent vaginal bleeding, and an associated myopathy (Kocher-Debré-Semelaigne syndrome). With the aid of pelvic sonography, we detected ovarian cysts.
The association of congenital hypothyroidism, myopathy, and precocious puberty has not been described before, to our knowledge; only that of congenital hypothyroidism and precocious puberty.1 We recently wrote an article on this subject, entitled "Pubertad Precoz y miopatia en el Hipotiroidismo Congénito" ("Myopathy and Precocious Puberty With Congenital Hypothyroidism"),2 for the new journal Acta Pediátrica de México, which is not yet included in the Index Medicus.
We believe that more frequent reporting of our unusual cases will show that