Association of polycystic ovary syndrome and Graves’ disease: Is autoimmunity the link between the two diseases

INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common endocrinopathy of women of child-bearing age. Although some studies have suggested an association between PCOS and autoimmune thyroiditis, to our knowledge, only a few cases indicating association between PCOS and Graves’ disease are reported. OBJECTIVE: We aim to describe this first case series of six women presenting with PCOS and Graves’ disease together. MATERIALS AND METHODS: Women attending the endocrinology clinic at a tertiary care centre in north India and fulfilling the AE-PCOS criteria for diagnosis of PCOS were studied using a predefined proforma for any clinical, biochemical and imaging features of Graves’ disease. RESULTS: The series consisted of six women with a mean age of 27.5 years and menarche as 12.6 years. All women were lean with mean BMI of 22.73 kg / m(2) and three out of six had waist circumference <80 cm. The mean FG score of subjects was 16.66 and average total testosterone was 77.02 ng / dl (25.0-119.64). All the patients had suppressed TSH, the average being 0.052 μIU/ml (0.01-0.15). Thyroid gland was enlarged in all clinically and on ultrasonography and imaging with (99m)Tc and/or RAIU revealed diffuse increased uptake. CONCLUSIONS: The association of a rare disorder like Graves’ disease with a relatively common disorder like PCOS is unlikely to be because of a chance alone and may point to a common aetiopathogenic linkage leaving a scope for molecular characterization.