To the Editor.
—Pseudoxanthoma elasticum (PXE) is a rare genetic disease involving multiple organs. Altman et al1 observed that two of their 16 patients with PXE had a history of hypothyroidism. We recently examined another patient from their original series (patient 14) because of the discovery of an abnormal thyroid gland.
Report of a Case.
—A 45-year-old euthyroid woman had a small (25 g) goiter that was firm, with a diffuse, finely nodular surface and a discrete 0.8× 1.0-cm, smooth nodule in the left upper pole. A Tc 99m thyroid scan showed diffuse, patchy uptake and a focal "cold" area corresponding to the palpable nodule. Thyroid-function tests were as follows: thyroxine (T4), 89 nmole/L (normal, 66 to 139 nmole/L); triiodothyronine uptake test, 36.4% (normal, 33% to 46%); thyroid-stimulating hormone (TSH), 3.4 μU/mL (normal, <5 μU/mL); and thyroid microsomal and thyroglobulin antibodies positive at a 1:6,400 titer. The diagnosis