Eponymous, anonymous: Queen Anne's sign and the misnaming of a symptom

Abstract

Tracing the historical origins of an eponymous medical sign can be fraught with dilemmas, particularly when the evidence for the naming comes from portraiture. Laterally truncated eyebrows, a sign of hypothyroidism, came to be associated with Anne of Denmark (1574-1619), James I's Queen Consort, likely because a contemporaneous portrait of her by Paul van Somer shows a woman with fair and abbreviated brows. Extant medical information on Anne, however, does not support a diagnosis of hypothyroidism, nor does her very active queenship point to such an affliction. Nonetheless, some authorities continue to employ the label, invoking Queen Anne's painted likeness as proof that she was goitrous and manifested the characteristically shortened eyebrows of those with a deficiency of thyroid activity.

Addisonian Crisis after Missed Diagnosis of Posttraumatic Hypopituitarism

“…Physical examination revealed dehydration, severe hypogonadism with loss of pubic, facial and axillary hair (Figure 1A), Queen Anne’s sign (loss of the outer third of the eyebrows as a clinical sign of hypothyroidism [4] (see red arrow Figure 1A), pale and waxen skin, muscular atrophy (Figure 1B) and low testicular volume. The patient’s initial basal hormone levels are presented in Table 1.…”

Madarosis: A marker of many Maladies

“…Loss of lateral one-third of eyebrows known as Hertoghe sign[38] is a characteristic sign of hypothyroidism. [52] Some people also refer to it as Queen Anne's sign,[53] after Anne of Denmark whose portrait with shortened eyebrows has been interpreted by some as indicative of the presence of goiter, even though such a fact has not been proved by any known sources of information. Madarosis may even be the presenting sign in hyperthyroidism.…”

Letter to the Editor

“…Sir: The title of the paper by Professor EL Furdell ( Journal of Medical Biography 2007; 15 :97–101) clearly indicates that Queen Anne's sign is misnamed. 1 She argues most convincingly that the Queen could not have been Anne of Denmark, James I's wife, nor Anne of France, Anne of Brittany, Anne of Austria, Anne Boleyn or Anne of Cleaves (two of the wives of Henry VIII) nor the Queen Anne, daughter of James II, we ordinarily think of when that name is used. This latter Queen Anne was not hypothyroid but suffered, I believe, from systemic lupus erythematosus which would explain at least 11 of the stillbirths resulting from her 17 pregnancies – a subject that I intend to write about in a forthcoming paper for the Journal of Medical Biography .…”