Multicystic ovaries detected by sonography

Four girls with long-standing primary hypothyroidism, three of whom had modest sexual precocity, were found to have multicystic ovaries when evaluated by pelvic sonography. The ovarian lesions were not evident clinically in three of the patients. The cysts regressed rapidly with thyroid replacement. The use of pelvic sonography may show that multicystic ovaries occur more frequently in profoundly hypothyroid girls than has been reported previously. There was a marked discrepancy between baseline plasma luteinizing hormone (LH) levels, which were elevated in three of four girls, and the urinary LH output, which was low or normal. Plasma and urinary follicle-stimulating hormone levels were normal. Two of three girls tested with luteinizing hormone-releasing hormone infusion had attenuated gonadotropin responses, while the third reacted normally. Our hormonal data do not provide an explanation for the cystic ovarian changes and early sexual development.