016 Case report: Turner syndrome

Abstract

This is the case report of a 16-year-old adolescent with Turner Syndrome and a family and personal background of migraines without auras. The diagnosis was at the neonatal stage with XO karyotype [ [1] Thayalan K, Chung K, Kothari A. Turner syndrome – The clinical spectrum and management dilemmas. AJUM November 2018 21 (4) 219. Google Scholar ]. Growth Hormone and steroid therapy to induce growth and puberty was prescribed [ [2] Irzyniec T. Jeż W. Lepska K. Maciejewska-Paszek I. Frelich J. Childhood growth hormone treatment in women with Turner syndrome - benefits and adverse effects. Sci Rep. 2019 Nov 4; 9: 15951 Crossref PubMed Scopus (11) Google Scholar ]. Sex hormone treatment consisted of transdermal estrogens in increasing doses. Over the last 6 months micronized progesterone was added and the patient had withdrawal bleeding [ [3] Viuff M.H. Berglund A. Juul S. Andersen N.H. Stochholm K. Gravholt C.H. Sex Hormone Replacement Therapy in Turner Syndrome: Impact on Morbidity and Mortality. J Clin Endocrinol Metab. 2020; (Feb 1;105(2):dgz039) Crossref PubMed Scopus (19) Google Scholar ]. Later on, the patient received contraceptives for a year as steroid substitution treatment [ [4] Mathez ALG, Monteagudo PT, do Nascimento Verreschi IT, Dias-da-Silva MR. Levonorgestrel correlates with less weight gain than other progestins during hormonal replacement therapy in Turner Syndrome patients. Sci Rep. 2020 May 19;10(1):8298. Google Scholar ]. The reason for consultation was a refusal to continue receiving contraceptives due to poor tolerance with permanent headaches and poor quality of life. An interdisciplinary approach was made and steroid treatment in Turner Syndrome patients was highlighted. The advised treatment was transdermal estrogens and cyclic micronized progesterone together with Topiramate to prevent migraines, and psychological support was recommended. Fertility counseling was performed [ [5] Oktay K. Bedoschi G. Berkowitz K. Bronson R. Kashani B. McGovern P. et al. Fertility Preservation in Women with Turner Syndrome: A Comprehensive Review and Practical Guidelines. J Pediatr Adolesc Gynecol. 2016 Oct; 29: 409-416 Abstract Full Text Full Text PDF PubMed Scopus (78) Google Scholar ].