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A 12 year old girl came to the clinic with her mother, complaining of short stature, delayed in puberty and developmental delay. Her karyotype study revealed 45X and confirmed the diagnosis of Turner syndrome. She is treating with GH since 6 months ago without estrogen therapy to avoid menarche and reach the ideal height. She is an obese, mentally retarded girl in the physical exam. Her breast bulb were in stage 1 with no course hair in the pubic or axillary. Her TSH was 3 and FBS was 75 in the latest lab study.