[Clinical and genetic analysis of a case of Turner syndrome with rapidly progressive puberty and a literature review].

Zhonghua Yi Xue Yi Chuan Xue Za Zhi

Department of Pediatrics, Shenzhen People's Hospital, the Second Clinical Medical College of Jinan University, the First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong 518020, China.

Published: August 2023

AI Article Synopsis

  • The study aimed to understand the clinical features and genetic causes of a child with Turner syndrome (TS) who experienced rapid puberty progression, collecting data and performing genetic analysis.
  • The 13-year-old patient exhibited early signs of puberty and had a specific karyotype (46,X,i(X)(q10)), alongside physical characteristics like short stature and multiple nevi.
  • Literature review revealed similar cases with common traits of short stature and chromosomal mosaicisms, highlighting the unique clinical manifestations associated with Turner syndrome and rapid puberty development.*

Article Abstract

Objective: To investigate the clinical features and genetic etiology of a case of Turner syndrome (TS) with rapidly progressive puberty.

Methods: A child who had presented at the Pediatric Endocrinology Clinic of the Shenzhen People's Hospital on January 19, 2022 was selected as the study subject. Clinical data of the child were collected. Peripheral blood sample of the child was subjected to chromosomal microarray analysis (CMA) and multiple ligation-dependent probe amplification (MLPA). Previous studies related to TS with rapidly progressive puberty were retrieved from the CNKI, Wanfang Data Knowledge Service Platform, Boku, CBMdisc and PubMed databases with Turner syndrome and rapidly progressive puberty as the keywords. The duration for literature retrieval was set from November 9, 2021 to May 31, 2022. The clinical characteristics and karyotypes of the children were summarized.

Results: The child was a 13-year-and-2-month-old female. She was found to have breast development at 9, short stature at 10, and menarche at 11. At 13, she was found to have a 46,X,i(X)(q10) karyotype. At the time of admission, she had a height of 143.5 cm (< P3), with 6 ~ 8 nevi over her face and right clavicle. She also had bilateral simian creases but no saddle nasal bridge, neck webbing, cubitus valgus, shield chest or widened breast distance. She had menstruated for over 2 years, and her bone age has reached 15.6 years. CMA revealed that she had a 58.06 Mb deletion in the Xp22.33p11.1 region and a 94.49 Mb duplication in the Xp11.1q28 region. MLPA has confirmed monosomy Xp and trisomy Xq. A total of 13 reports were retrieved from the CNKI, Wanfang Data Knowledge Service Platform, Boku, CBMdisc and PubMed databases, which had included 14 similar cases. Analysis of the 15 children suggested that their main clinical manifestations have included short stature and growth retardation, and their chromosomal karyotypes were mainly mosaicisms.

Conclusion: The main clinical manifestations of TS with rapidly progressive puberty are short stature and growth retardation. Deletion in the Xp22.33p11.1 and duplication in the Xp11.1q28 probably underlay the TS with rapid progression in this child, which has provided a reference for clinical diagnosis and genetic counselling for her.

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Source
http://dx.doi.org/10.3760/cma.j.cn511374-20220721-00484DOI Listing

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