We report the case of a 7-yr-old girl with Turner syndrome, ulcerative colitis (UC) and coarctation of the aorta. The diagnosis of Turner syndrome was made in early infancy (karyotype analysis 45, X). Growth hormone treatment was started at 3 yr and 2 mo of age. From the age of 4 yr and 5 mo, the patient suffered from persistent diarrhea with traces of blood and intermittent abdominal discomfort. As these symptoms gradually deteriorated, she was referred to our clinic at the age of 7 yr for further evaluation. Barium enema showed aphtha and loss of the fine network pattern in the descending colon and rectum. An endoscopic examination showed ulceration, edema, friability, and erythema beginning in the rectum and extending up to the splenic flexure of the descending colon. The histology of the descending colon area showed severe stromal infiltration of inflammatory cells. These endoscopic findings and the histological findings were consistent with UC. Thus, based on these findings, the patient was diagnosed as having UC. Mesalazine therapy was initiated at this time. The patient is currently being treated with mesalazine (1,000 mg/day) and abdominal symptoms and bloody diarrhea have disappeared. GH therapy was not interrupted during the therapy for UC. Retrospectively, growth hormone improved growth velocity (9 cm/year) during the first year of treatment, however from the age of 4 yr, growth velocity decreased (4–5 cm/yr) in spite of the GH treatment. Conclusion: Patients with Turnersyndrome and gastrointestinal symptoms should be investigated for inflammatory boweldiseases. Growth velocity is useful for evaluating the presence of inflammatory boweldiseases and other systemic diseases.
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机译:我们报告了一个7岁的特纳综合征,溃疡性结肠炎(UC)和主动脉缩窄的女孩的情况。特纳综合征的诊断是在婴儿早期进行的(核型分析45,X)。生长激素治疗始于3岁零2个月大。从4岁到5个月大,患者持续腹泻,并伴有血液痕迹和间歇性腹部不适。随着这些症状逐渐恶化,她于7岁被转介到我们的诊所接受进一步评估。钡灌肠在下降的结肠和直肠中显示出口疮和精细网络模式的丧失。内窥镜检查显示溃疡,水肿,易碎和红斑从直肠开始,一直延伸到降结肠的脾曲。降结肠区域的组织学表现为炎性细胞的严重基质浸润。这些内镜检查结果和组织学检查结果与UC一致。因此,基于这些发现,该患者被诊断为患有UC。美沙拉嗪治疗在此时开始。该患者目前正在接受美沙拉嗪(1,000毫克/天)的治疗,腹部症状和血性腹泻已经消失。 UC治疗期间不中断GH治疗。回顾性地,生长激素在治疗的第一年提高了生长速度(9 cm /年),但是从4岁开始,尽管进行了GH治疗,生长速度却下降了(4-5 cm / yr)。结论:特纳患者综合征和胃肠道症状应调查炎症性肠疾病。生长速度有助于评估炎症性肠的存在疾病和其他全身性疾病。
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