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Kwon, Chon, Koh, Oh, Woo, Kim, Kim, and Kim: A Case of 45,X Turner's Syndrome with Iron Deficiency Anemia due to Menometrorrhagia and Spontaneous Sexual Development
Case Report
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2005; 20(2): 160-167.

Published online: 20 April 2005

DOI: https://doi.org/10.3803/jkes.2005.20.2.160

A Case of 45,X Turner's Syndrome with Iron Deficiency Anemia due to Menometrorrhagia and Spontaneous Sexual Development

Mi Kwang Kwon, Suk Chon, Gwan Pyo Koh, Seung Jun Oh, Jeong Taek Woo, Sung Woon Kim, Jin Woo Kim, Young Seol Kim

Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul, Korea.

Received 11 October 2004       Accepted 24 February 2005

Copyright © 2005 Korean Endocrine Society

Abstract

Short stature and gonadal dysgenesis are two characteristic clinical features of Turners syndrome. Very rarely, patients with Turners syndrome may menstruate and even be fertile. We experienced a case of Turners syndrome with spontaneous sexual development and menstruation. A 16-year-old girl was referred for severe anemia and menometrorrahgia. She had nearly normal features, with the exception of a short stature and a single right kidney. Also, she had spontaneous development of secondary sexual characteristics. We performed and anemia study and evaluated her short stature. In chromosomal study of her bone marrow and peripheral blood lymphocytes, she was revealed to have monosomy 45,X. Herein, this case is reported, with a brief review of literature.

Keywords: Turners syndrome, Anemia, Menometrorrhagia, Spontaneous sexual development

Figures and Tables

Fig. 1
Kidney and pelvis MRI showed only one kidney and agenesis of left kidney.
Panel A shows that she has unilateral right kidney and right ovarian cyst (diameter 1.9 cm) and panel B shows left ovarian cyst (diameter 2.0 cm).
jkse-20-160-g001
Fig. 2
General appearance of a 16-year-old 45,X girl, with short stature. She was looked well secondary sexual development.
jkse-20-160-g002
Fig. 3
Pelvic ultrasonography showed both ovarian cysts and endometrial thickening.
(A, right ovarian cyst-size 1.54 cm; B, left ovarian cyst-size 3.49 cm; C, endometrial thickness was 0.66 cm)
jkse-20-160-g003
Fig. 4
Bone age on hand.
Patient's wrist X-ray revealed a 15-year-old and complete epiphyseal plate closure
jkse-20-160-g004
Fig. 5
Karyotype from peripheral blood lymphocyte showed 45,X
jkse-20-160-g005
Table 1
Combined Pituitary Stimulation test with Insulin, TRH and LHRH
jkse-20-160-i001

†; Not only FSH and LH but also estradiol and progesterone levels are within normal range in this patient, as compared with hormone levels observed during follicular phase in normal women.

* ; T3: triiodothronine (40~200 ng/dL), T4: thyroxine (4.5~12 ug/dL), ACTH: adrenocorticotropin hormone(10~60 pg/mL), GH: growth hormone (<0.5 ng/mL), FSH: follicle stimulating hormone (1.7~8.5 mIU/mL), LH: luteinizing hormone (2~15.4 mIU/mL), PRL: prolactin (0.2~9.4 ng/mL), TSH: thyroid stimulating hormone (0.3~4.0 U/mL), estradiol (follicular phase: 30~100 pg/mL, luteinizing phase: 70~300 pg/mL, ovulatory phase: 156~325 pg/mL), progesterone (follicular phase <3 ng/mL, luteinizing phase >10 ng/mL).

( ); showed in normal range

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