An Unusual Manifestation of Celiac Disease in an Adolescent With Down Syndrome and Graves Disease

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Individuals with Down syndrome (DS) have an increased prevalence of autoimmune disorders, with reported rates of 3% to 54% for thyroid disorders and 5% to 20% for celiac disease (CD) (1–3). CD can present with extraintestinal manifestations such as poor growth, osteoporosis, neuropsychiatric manifestations, delayed puberty, infertility, and menstrual irregularities (4,5). We describe an adolescent girl with DS and Graves disease presenting with polymenorrhea as the initial symptom of CD.

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