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八十岁女性的特纳综合征诊断

A Diagnosis of Turner Syndrome in the Eighth Decade of Life.

作者信息

Kaur Ruveena, O'Sullivan Susannah

机构信息

Department of Endocrinology, Greenlane Clinical Centre, Auckland 1051, New Zealand.

出版信息

JCEM Case Rep. 2024 Jun 21;2(6):luae104. doi: 10.1210/jcemcr/luae104. eCollection 2024 Jun.

Abstract

Turner syndrome (TS) is the most common sex chromosome disorder affecting females and is usually diagnosed within the first 3 decades of life. It can present with primary amenorrhea or infertility and often has a typical phenotype, with associated medical conditions that require lifelong surveillance. We report the case of a 76-year-old female with a history of osteoporosis and vertebral fractures who presented to our specialist osteoporosis clinic following a neck of femur fracture. She revealed a history of short stature and primary amenorrhea as a young woman, with limited investigation and treatment. Her other medical history included coeliac disease, hypertension, and hearing and vision abnormalities. Given her phenotype, the patient was referred for a karyotype at age 76, which was consistent with mosaic TS (45, X in 78% of cells and 46, X, r(Y) in the remaining cells). We review reports of other cases of marked delay in TS diagnosis and discuss the consequences of a late diagnosis.

摘要

特纳综合征(TS)是影响女性最常见的性染色体疾病,通常在生命的前三十年被诊断出来。它可表现为原发性闭经或不孕,且往往具有典型的表型,并伴有需要终身监测的相关疾病。我们报告了一例76岁女性患者,她有骨质疏松症和椎体骨折病史,因股骨颈骨折前来我们的骨质疏松专科门诊就诊。她透露年轻时有身材矮小和原发性闭经病史,当时检查和治疗有限。她的其他病史包括乳糜泻、高血压以及听力和视力异常。鉴于她的表型,该患者在76岁时被转诊进行核型分析,结果与嵌合型TS一致(78%的细胞为45,X,其余细胞为46,X,r(Y))。我们回顾了其他TS诊断明显延迟的病例报告,并讨论了延迟诊断的后果。

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1
A Case Report of Turner Syndrome Diagnosed at Age 61 Years.
J Menopausal Med. 2023 Dec;29(3):143-145. doi: 10.6118/jmm.23028.
2
Missed opportunities in the treatment of Turner syndrome: a case discussion and review of the guidelines.
BMJ Case Rep. 2022 Aug 17;15(8):e250870. doi: 10.1136/bcr-2022-250870.
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Endocr Rev. 2023 Jan 12;44(1):33-69. doi: 10.1210/endrev/bnac016.
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Cardiovascular Health in Turner Syndrome: A Scientific Statement From the American Heart Association.
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