Yu Jung, Shin Ha Young, Lee Chong Guk, Kim Jae Hyun
Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea.
Korean J Pediatr. 2016 Nov;59(Suppl 1):S121-S124. doi: 10.3345/kjp.2016.59.11.S121. Epub 2016 Nov 30.
Turner syndrome (TS) is a genetic disorder in phenotypic females that has characteristic physical features and presents as partial or complete absence of the second sex chromosome. Growth hormone deficiency (GHD) is a condition caused by insufficient release of growth hormone from the pituitary gland. The concomitant occurrence of TS and GHD is rare and has not yet been reported in Korea. Here we report 2 cases of TS and GHD. In case 1, GHD was initially diagnosed. Karyotyping was performed because of the presence of the typical phenotype and poor response to growth hormone therapy, which revealed 45,X/45,X+mar. The patient showed increased growth velocity after the growth hormone dose was increased. In case 2, a growth hormone provocation test and chromosomal analysis were performed simultaneously because of decreased growth velocity and the typical TS phenotype, which showed GHD and a mosaic karyotype of 45,X/46,XX. The patient showed spontaneous pubertal development. In female patients with short stature, it is important to perform a throughout physical examination and test for hormonal and chromosomal abnormalities because diagnostic accuracy is important for treatment and prognosis.
特纳综合征(TS)是一种发生于表型女性的遗传性疾病,具有特征性的身体特征,表现为部分或完全缺失第二条性染色体。生长激素缺乏症(GHD)是一种由垂体腺分泌生长激素不足引起的病症。TS和GHD同时出现的情况较为罕见,韩国尚未有相关报道。在此,我们报告2例TS合并GHD的病例。病例1最初诊断为GHD。由于存在典型表型且对生长激素治疗反应不佳,遂进行了核型分析,结果显示为45,X/45,X+mar。在增加生长激素剂量后,该患者的生长速度加快。病例2因生长速度减慢和典型的TS表型,同时进行了生长激素激发试验和染色体分析,结果显示存在GHD以及45,X/46,XX的嵌合核型。该患者出现了自发的青春期发育。对于身材矮小的女性患者,进行全面的体格检查以及激素和染色体异常检测非常重要,因为诊断准确性对于治疗和预后至关重要。