A 24-year-old woman with both lipoid CAH and Graves’ disease presented to the department of endocrinology, Shengjing Hospital of China Medical University with a complaint of regular follow-up and hormone medication dosage adjustment. The patient receives regular follow-ups in the outpatient division of the endocrinology department in our hospital, and the hormone dosage is adjusted according to the results of relevant biochemical examinations. 23 years ago, the skin of the patient gradually darkened, with obvious skin folds, palm lines, and gingival pigmentation. 21 years ago, due to her coarse voice, boyishness, preference for salt, love of drinking, poor appetite, and a higher rate of growth and development than her peers, she was brought to the pediatrics department of our hospital. Examinations revealed that serum cortisol (COR) levels were low and ACTH was high. The patient was subsequently diagnosed with “CAH.” After treatment with hydrocortisone, her skin pigmentation improved slightly. 9 years ago, the treatment was changed to dexamethasone according to her doctor's advice, and her skin pigmentation improved significantly. Furthermore, her growth rate was noted to be the same as that of her peers. 3 years ago, the patient went to an endocrine clinic due to palpitations and weight loss. There, she was diagnosed with Graves' disease. After treatment with methimazole, the patient developed a rash all over her body. Subsequently, she stopped methimazole and received 131 iodine radiation therapy. The patient was born at full term without any birth injuries. Her parents were non-consanguineous and had no family history of hereditary diseases. Physical examination showed blood pressure of 120/80 mmHg, heart rate of 70 beats/min, height of 1.71 m, weight of 70 kg, and a BMI of 23.9 kg/m2. Skin folds; palm lines; lip and gingival pigmentation; thyroid I swelling; no armpit hair; and Tanner scale: Breast development stage V, pubic hair stage V, and normal external genitalia were noted. The patient's blood routine examination, liver and kidney function, serum ions, and blood glucose were all normal. The results of the relevant hormones of the patient are shown in Table. Except for slightly lower progesterone, other sex hormones were normal. The patient had low serum COR, low aldosterone (12.240 pg/mL; normal, 70-300 pg/mL), and high plasma renin (16.137 ng/mL; normal, 0.10-6.56 ng/mL). However, ACTH levels fluctuated as the exogenous glucocorticoids supplemented dosage changed. A uterine ultrasound revealed that the size of the uterus was 7.2 cm × 4.5 cm × 2.7 cm, the endometrial thickness was about 0.6 cm, the left ovary was 3.4 cm × 2 cm, and the right ovary was 3.6 cm × 2.3 cm. Enhanced magnetic resonance imaging of the pituitary gland showed that the volume of the pituitary gland was increased significantly. Enhanced computed tomography of the adrenal glands showed punctate calcification of the left adrenal gland.