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A rare case of salt wasting type of Congenital Adrenal Hyperplasia with Turner Syndrome

Authors: Karan B Patel; Lavanya Bandipelly; Parth Sanandiya;

A rare case of salt wasting type of Congenital Adrenal Hyperplasia with Turner Syndrome

Abstract

{"references": ["Huynh T, McGown I, Cowley D, Nyunt O, Leong GM, Harris M, Cotterill AM. The clinical and Biochemical spectrum of congenital adrenal hyperplasia secondary to 21-hydroxylase deficiency. Clin Biochem Rev. 2009;30:75\u201386.", "Saenger P. Turner Syndrome. In: Sperling MA (ed), editor. Pediatric Endocrinology (3rd ed) Philadelphia: w Saunders Co; 2008. pp. 610\u2013661.", "Maciel-Guerra AT, Guerra G Jr, Marini SH, Matias Baptista MT, Marques-de-Faria AP. Female pseudohermaphroditism due to classical 21-hydroxylase deficiency in a girl with Turner syndrome. Clin Genet. 1997;51:351\u2013353.", "Atabek ME, Kurtoglu S, Keskin M. Female pseudohermaphroditism due to classical 21-hydroxylase deficiency and insulin resistance in a girl with Turner syndrome. Turk J Pediatr. 2005;47:176\u2013179.", "del Arbol JL, Soto Mas JA, Fernandez-Abril JA, Raya Munoz J, Martinez Tormo F, Gomez Rodriguez J, Gomez Capilla JA, Pena Yanez A. Turner syndrome caused by deletion of the long arm of the X chromosome associated with adrenogenital syndrome caused by partial deficiency of 21-hydroxylase. Rev Clin Esp. 1983;171:67\u201371.", "Montemayor-Jauregui MC, Ulloa-Gregori AO, Flores-Briseno GA. Associated adrenogenital and Turner's syndrome mosaicism. Plast Reconstr Surg. 1985;75:877\u2013881.", "Larizza D, Cuccia M, Martinetti M, Maghnie M, Dondi E, Salvaneschi L, Sever F. Adrenocorticotropin stimulation and HLA polymorphisms suggest a high frequency of heterozygosity for steroid 21-hydroxylase deficiency in patients with Turner's syndrome and their families. Clin Endocrinol (Oxf) 1994;40:39\u201345.", "Cohen MA, Sauer MV, Lindheim SR. 21-hydroxylase deficiency and Turner's syndrome: a reason for diminished endometrial receptivity. Fertil Steril. 1999;72:937\u2013939.", "Mantovani V, Dondi E, Larizza D, Cisternino M, Bragliani M, Viggiani M, Martinetti M, Cuccia M. Do reduced levels of sterois 21-hyroxylase confer a survival advantage in fetuses affected by sex chromosome aberrations? Eur J Hum Genet. 2002;10:137\u2013140.", "Linglart A, Cabrol S, Berlier P, Stuckens C, Wagner K, Kerdanet M, de, Limoni C, Carel JC, Chaussain JL French Collaborative Young Turner Study Group. Growth hormone treatment before the age 4 years prevents short stature in young girls with Turner Syndrome. Eur J Endocrinol. 2011;164:891\u2013897."]}

ABSTRACT Combination of Congenital Adrenal Hyperplasia (CAH) with Turner Syndrome (TS) is rare. We report a 20-days old new born, born from second degree consanguineous marriage presented with refusal of feeds, vomiting and loose stools. On examination, ambiguous genitalia with presence of a 2.6 cm phallus, incomplete labial fusion, gonads not palpable and hyperpigmentation were noted. Laboratory findings revealed a classical type of CAH caused by 21-hydroxylase deficiency. Karyotyping showed a 45 X0[4] / 46 XX[16] pattern concluding mosaic TS. She was given hydrocortisone at a dose of 5 mg/m2/day, fludrocortisone acetate in dose of 0.1mg/day, along with oral salt of 1 gm/day. At 8 months follow-up, the patient appeared to be in good health; her height was 69.3 cm [> 50th percentile] and her weight was 8.3 kg (> 50th percentile). System examinations turned out to be normal. The patient’s electrolyte levels were normal and she was in good metabolic control. The findings of this particular patient show that routine karyotyping during investigation of patients with disorders of sexual differentiation (DSD) can help us to reveal TS. Additionally, signs of virilism have to be investigated at the time of diagnosis or during physical examinations for proper follow-up of TS cases.

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Keywords

Congenital Adrenal Hyperplasia, Medicine (General), R5-920, Turner syndrome, Karyotyping, turner syndrome, congenital adrenal hyperplasia, Disorders of Sexual Differentiation, disorders of sexual differentiation, karyotyping

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This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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