Meena Alpana, Daga Mradul Kumar, Dixit Rashmi
Department of Medicine, Maulana Azad Medical College, New Delhi, Delhi, India.
Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, Delhi, India.
BMJ Case Rep. 2016 May 20;2016:bcr2015212634. doi: 10.1136/bcr-2015-212634.
Gonadal dysgenesis and Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) are the most common causes of primary amenorrhoea. Patients with gonadal dysgenesis present with primary amenorrhoea and lack of secondary sexual characteristics, which, in contrast, are present in patients with MRKHS. The coexistence of the 2 syndromes has been reported in only a few studies so far. We describe a case of a 15-year-old girl who presented with short stature and primary amenorrhoea. Investigations revealed hypergonadotropic hypogonadism, and absence of the uterus, and upper two-thirds of the vagina, with presence of the rudimentary lower third of the vagina and non-visualised bilateral ovaries on imaging. Karyotyping obtained by lymphocyte culture GTG banding revealed 45X/46XX. The patient was diagnosed as having a rare case of gonadal dysgenesis with MRKH. She was started on growth hormone therapy. The association of these syndromes is uncommon, and has further implications on fertility and pregnancy, affecting the quality of life.
性腺发育不全和迈耶-罗基坦斯基-库斯特-豪泽综合征(MRKHS)是原发性闭经最常见的病因。性腺发育不全患者表现为原发性闭经且缺乏第二性征,而MRKHS患者则有第二性征。到目前为止,仅有少数研究报道过这两种综合征并存的情况。我们描述了一例15岁女孩,她身材矮小且原发性闭经。检查发现高促性腺激素性性腺功能减退,子宫缺如,阴道上三分之二缺如,影像学检查显示阴道下三分之一发育不全,双侧卵巢未见。通过淋巴细胞培养GTG显带进行的核型分析显示为45,X/46,XX。该患者被诊断为罕见的合并MRKH的性腺发育不全病例。她开始接受生长激素治疗。这些综合征的关联并不常见,对生育和妊娠有进一步影响,会影响生活质量。