Editing Turner syndrome (section)

====Autoimmune====
Women with Turner syndrome are two to three times as likely to develop [[autoimmune disorder]]s as the general population. Specific autoimmune disorders linked to Turner syndrome include [[Hashimoto's disease]], [[vitiligo]], [[psoriasis]] and [[psoriatic arthritis]], [[alopecia]],[[Type I diabetes]], and [[celiac disease]] Type I diabetes, when the immune system attacks the beta cells in the pancreas, is a major autoimmune disorder and is much more common in Turner females than 46,XX and 47,XXX females in most cases.<ref name="Haskin Lowenstein Dermatologic Conditions in Turner Syndrome">{{cite book |doi=10.1007/978-3-030-34150-3_13 |chapter=Dermatologic Conditions in Turner Syndrome |title=Turner Syndrome |date=2020 |last1=Haskin |first1=Alessandra |last2=Lowenstein |first2=Eve |pages=221–236 |isbn=978-3-030-34148-0 }}</ref> [[Inflammatory bowel disease]] is also common,<ref name="Wahbeh Bradshaw White Lee Gastrointestinal and Hepatic Issues in Women with Turner Syndrome">{{cite book |doi=10.1007/978-3-030-34150-3_12 |chapter=Gastrointestinal and Hepatic Issues in Women with Turner Syndrome |title=Turner Syndrome |date=2020 |last1=Wahbeh |first1=Ghassan T. |last2=Bradshaw |first2=Amanda |last3=White |first3=Lauren |last4=Lee |first4=Dale |pages=205–220 |isbn=978-3-030-34148-0 }}</ref> while the prevalence of [[type 1 diabetes]] is unclear, though appears increased.<ref name="Viuff Gravholt Endocrine and Metabolic Consequences of Turner Syndrome">{{cite book |doi=10.1007/978-3-030-34150-3_8 |chapter=Endocrine and Metabolic Consequences of Turner Syndrome |title=Turner Syndrome |date=2020 |last1=Viuff |first1=Mette H. |last2=Gravholt |first2=Claus H. |pages=157–174 |isbn=978-3-030-34148-0 }}</ref>

Thyroid disease is common in Turner syndrome. [[Hypothyroidism]] is prevalent; 30%–50% of women with Turner syndrome have Hashimoto's disease, where the thyroid gland is slowly destroyed by an autoimmune reaction from the immune system. By age 50, half of women with Turner syndrome have subclinical or clinical hypothyroidism.<ref name="Viuff Gravholt Endocrine and Metabolic Consequences of Turner Syndrome"/> [[Hyperthyroidism]] and [[Graves' disease]] are also increased in prevalence, though more modestly. The Turner's presentation of hyperthyroidism is as in the general population, while the presentation of hypothyroidism is often atypical, with a mild early presentation yet a more severe progression.<ref name="ijp">{{cite journal | vauthors = Aversa T, Gallizzi R, Salzano G, Zirilli G, De Luca F, Valenzise M | title = Atypical phenotypic aspects of autoimmune thyroid disorders in young patients with Turner syndrome | journal = Italian Journal of Pediatrics | volume = 44 | issue = 1 | pages = 12 | date = January 2018 | pmid = 29343299 | pmc = 5773039 | doi = 10.1186/s13052-018-0447-3 | doi-access = free }}</ref> Women with isochromosome Xq are more likely to develop autoimmune thyroid disease than women with other forms of Turner syndrome.<ref name="Viuff Gravholt Endocrine and Metabolic Consequences of Turner Syndrome" />

The risk of irritable bowel syndrome is increased around fivefold in Turner syndrome, and that of [[ulcerative colitis]] around fourfold. Celiac disease is also increased in prevalence, with around 4–8% of Turner's patients having comorbid celiac disease compared to 0.5–1% of the general population. Diagnosis of such conditions is difficult due to their nonspecific early symptoms. In the Turner's context, diagnosis may in particular be missed due to growth delay; such conditions cause growth delay and failure to thrive when they onset in childhood, but as girls with Turner syndrome already have such delay, symptoms may be overlooked and ascribed to the original condition.<ref name="Wahbeh Bradshaw White Lee Gastrointestinal and Hepatic Issues in Women with Turner Syndrome"/>

[[Alopecia areata]], or recurrent patchy hair loss, is three times as common in Turner syndrome as the general population. Alopecia in the Turner syndrome context is frequently treatment-resistant, also seen in other chromosome [[aneuploidies]] such as [[Down syndrome]]. Psoriasis is common in Turner syndrome, although the precise prevalence is unclear. Turner's psoriasis may be related to growth hormone treatment, as psoriasis as a side effect of such therapies has been reported in patients without the karyotype. Psoriasis may progress to [[psoriatic arthritis]], and this progression may be more common in Turner syndrome. Vitiligo has been reported in conjunction with Turner syndrome, but the risk is unclear and may be a side effect of increased clinical attention to autoimmune disease in this population.<ref name="Haskin Lowenstein Dermatologic Conditions in Turner Syndrome" />