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三例青春期卵巢功能不全少女的常染色体微缺失:病例报告。

Autosomal chromosome microdeletions in three adolescent girls with premature ovarian insufficiency: a case report.

机构信息

Department of Pediatrics, The First Affiliated Hospital, College of Medience, Zhejiang University, China.

出版信息

Turk J Pediatr. 2022;64(4):729-735. doi: 10.24953/turkjped.2021.749.

Abstract

BACKGROUND

Premature ovarian insufficiency (POI) in the pediatric age group is most commonly related to X chromosome abnormalities such as Turner syndrome. Autosomal chromosome microdeletions in ovarian failure are relatively rare. The present study identified new autosomal deletions in three girls with POI.

CASE

We present three adolescent girls aged 14-15 years who had not attained menarche. Upon physical examination, there was a lack of breast tissue and no prominent secondary sexual characteristics. Clinical evaluation, hormonal tests, abdominal ultrasonography, and chromosome karyotyping were performed. Chromosome microarray analysis (CMA) was also performed to detect DNA copy number changes. Luteinizing hormone level was significantly increased, while follicular stimulating hormone level was > 25 IU/L with low estradiol levels. Autosomal deletions were detected in all three cases by CMA. The first patient had 0.454 Mb deletion on 15q25.2, the second patient had 1.337 Mb deletion on 19p13.3, and the third patient had 0.163 Mb deletion on 16p11.2.

CONCLUSIONS

POI is rare in children and is most commonly associated with X chromosome abnormalities. However, normal karyotype does not exclude the presence of chromosomal abnormality. CMA should be considered in cases with POI to detect microdeletions in autosomal chromosomes.

摘要

背景

儿科年龄段的卵巢早衰(POI)最常与 X 染色体异常有关,如特纳综合征。卵巢衰竭的常染色体微缺失相对较少。本研究在三名 POI 女孩中发现了新的常染色体缺失。

病例

我们介绍了 3 名 14-15 岁的青春期女孩,她们尚未出现初潮。体格检查时,乳房组织缺乏,没有明显的第二性征。进行了临床评估、激素测试、腹部超声检查和染色体核型分析。还进行了染色体微阵列分析(CMA)以检测 DNA 拷贝数变化。黄体生成素水平显著升高,而卵泡刺激素水平> 25 IU/L,雌二醇水平较低。CMA 在所有 3 例中均检测到常染色体缺失。第一例患者在 15q25.2 上有 0.454 Mb 的缺失,第二例患者在 19p13.3 上有 1.337 Mb 的缺失,第三例患者在 16p11.2 上有 0.163 Mb 的缺失。

结论

儿童中 POI 很少见,最常与 X 染色体异常有关。然而,正常核型并不能排除染色体异常的存在。对于 POI 病例,应考虑进行 CMA 以检测常染色体微缺失。

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