98.2.16 Discussion Presentation

ID and Source of the History
36 y/o woman
from Tehran ,
Divorced

Source of the history  : 
Patient and her mother (reliable)

Present  illness
The patient is a 36 years old girl who has been referred to the endocrine clinic for short stature.
at 11 Y/O she referred to  the endocrinology clinic due to her short stature and special feature: round face and brachydactyly .
The Karyotype done for her reported mosaicism for turner(46XX-45XO ) .
No F/U or treatment was done for her since 13 Y/O.

14 y/o ( 1376 )
She  was taken to the emergency room due to severe Carpopedal spasm , abdominal pain  and generalized cramps.
On W/U, significant hypocalcemia and high PTH levels were detected (no documentation available) .
She was under treatment with calcitriol and Calcium since 22 years ago until now.
Another symptomatic hypocalcemia has not happened as yet.
During this admission  also high TSH and low T4 levels were detected and she was prescribed levothyroxine which used irregular.  

P.I

menstruation was started at about 10 Y/O. It was regular and it's duration was about 7 days.

doctors suspected  accuracy of turner diagnosis because of the regular menstruation, so; they reevaluated karyotype analysis which it's result was normal(46xx)!    

At the age of 27, when she got divorced, she was diagnosed to have MDD and she became amenorrhea. Then she visited a gynecologist and  psychologist.

By using 2 amp progesterone  and cyproterone compound her menstruation became regular but her gynecologist didn't follow up the FSH & LH levels before the use of the drugs.

P.M.H
Hypothyroidism
Attack of hypocalcemia =1 upon a time
MDD
No Renal stone
orthodontia