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Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications
A 16.5-year-old Indian female presented with secondary amenorrhoea, cubitus valgus, scoliosis and multiple lentigines on the face. Karyotyping revealed mosaic Turner syndrome (TS) with 45, X/46, X iXq. She also had multiple café-au-lait macules and axillary freckles but no neurofibroma and did not f...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Journal of the ASEAN Federation of Endocrine Societies
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10213385/ https://www.ncbi.nlm.nih.gov/pubmed/37252421 http://dx.doi.org/10.15605/jafes.038.01.20 |
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author | Mondal, Sunetra Agrawal, Neha Chowdhury, Subhankar |
author_facet | Mondal, Sunetra Agrawal, Neha Chowdhury, Subhankar |
author_sort | Mondal, Sunetra |
collection | PubMed |
description | A 16.5-year-old Indian female presented with secondary amenorrhoea, cubitus valgus, scoliosis and multiple lentigines on the face. Karyotyping revealed mosaic Turner syndrome (TS) with 45, X/46, X iXq. She also had multiple café-au-lait macules and axillary freckles but no neurofibroma and did not fulfil the classic criteria for diagnosis of Neurofibromatosis-1 (NF1). Many of her macules were smaller than 15 mm in diameter, which might be due to her hypoestrogenic state. However, exome-sequencing found a pathologic variant consistent with NF1. She was started on daily oral estrogen, and oral progesterone for 10 days every month with close monitoring for neurofibroma and/or glioma expansion. Co-occurrence of NF1 and TS is extremely rare, TS and NF1 can both affect growth and puberty, cause different cutaneous and skeletal deformities, hypertension, vasculopathy and learning disabilities. Our case highlights the need for genetic testing in some cases with NF1 who do not strictly fulfil the NIH diagnostic criteria. We also emphasize the need for close monitoring during therapy with growth hormone, estrogen and progesterone due to the potential risk of tumour expansion in NF1. |
format | Online Article Text |
id | pubmed-10213385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Journal of the ASEAN Federation of Endocrine Societies |
record_format | MEDLINE/PubMed |
spelling | pubmed-102133852023-05-27 Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications Mondal, Sunetra Agrawal, Neha Chowdhury, Subhankar J ASEAN Fed Endocr Soc Case Report A 16.5-year-old Indian female presented with secondary amenorrhoea, cubitus valgus, scoliosis and multiple lentigines on the face. Karyotyping revealed mosaic Turner syndrome (TS) with 45, X/46, X iXq. She also had multiple café-au-lait macules and axillary freckles but no neurofibroma and did not fulfil the classic criteria for diagnosis of Neurofibromatosis-1 (NF1). Many of her macules were smaller than 15 mm in diameter, which might be due to her hypoestrogenic state. However, exome-sequencing found a pathologic variant consistent with NF1. She was started on daily oral estrogen, and oral progesterone for 10 days every month with close monitoring for neurofibroma and/or glioma expansion. Co-occurrence of NF1 and TS is extremely rare, TS and NF1 can both affect growth and puberty, cause different cutaneous and skeletal deformities, hypertension, vasculopathy and learning disabilities. Our case highlights the need for genetic testing in some cases with NF1 who do not strictly fulfil the NIH diagnostic criteria. We also emphasize the need for close monitoring during therapy with growth hormone, estrogen and progesterone due to the potential risk of tumour expansion in NF1. Journal of the ASEAN Federation of Endocrine Societies 2023-02-17 2023 /pmc/articles/PMC10213385/ /pubmed/37252421 http://dx.doi.org/10.15605/jafes.038.01.20 Text en © 2023 Journal of the ASEAN Federation of Endocrine Societies https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
spellingShingle | Case Report Mondal, Sunetra Agrawal, Neha Chowdhury, Subhankar Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications |
title | Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications |
title_full | Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications |
title_fullStr | Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications |
title_full_unstemmed | Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications |
title_short | Turner Syndrome and Neurofibromatosis 1: Rare Co-Existence with Important Clinical Implications |
title_sort | turner syndrome and neurofibromatosis 1: rare co-existence with important clinical implications |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10213385/ https://www.ncbi.nlm.nih.gov/pubmed/37252421 http://dx.doi.org/10.15605/jafes.038.01.20 |
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