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Re: Turner's mosaic/thrombocytopenia From: Allen Gardner (allen.gardner@utoronto.ca) Wed Jun 4 19:48:15 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: jay kulkin: "Anal inc/ CME meeting" Previous message: Roberta Speyer: "OBGYN.net Weekly UPDATE" Maybe in reply to: Laurie Lovely: "Turner's mosaic/thrombocytopenia" Hi. I've had no experience with this type of problem, but I am curious. Is Growth Hormone standard for Turner's syndrome? Allen. -- ==================================================== On Wed, 4 Jun 1997 11:20:44 -0400 Laurie Lovely wrote: > From: Laurie Lovely <llovely@med.unc.edu> > Date: Wed, 4 Jun 1997 11:20:44 -0400 > Subject: Turner's mosaic/thrombocytopenia > To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> > > Dear Listers, > I am now seeing an obese 14-year-old girl with short stature who was > diagnosed with 46XX/45X karyotype after bone marrow analysis during > workup of her thrombocytopenia. She is also an insulin-dependent > diabetic. The hematologists have been unable to fully characterize her > thrombocytopenia, but they suspect it is an X-linked form. The > thrombocytopenia appeared to improve somewhat with initiation of her > growth hormone treatment (begun after her karyotype was determined), but > she still has wild swings in her platelet levels. > > The problem is that she has begun to have vaginal bleeding. Her > gonadotropins are currently in the normal range with normal estradiol, > so I believe she is having ovarian function. A transabdominal > ultrasound during an episode of her bleeding showed an endometrial > stripe of 3 mm. She has been taking continuous oral contraceptives for > 2-1/2 months but has continued to have sporadic episodes of bleeding, > usually correlated with platelet nadirs. Since she has a > high-maintenance medication regimen already (growth hormone, insulin), I > would like to keep her meds as simple as possible (i.e., avoid monthly > Depot-Lupron with add-back therapy). If anyone has experience in > managing a related problem, I would love to hear suggestions. This > patient, her mother, and I thank you in advance. > > -- > Laurie Lovely, MD > RE fellow, UNC-Chapel Hill Allen Gardner MD, Genetics Oshawa General Hospital Oshawa, Ontario, L1G 2B9, Canada Next message: jay kulkin: "Anal inc/ CME meeting" Previous message: Roberta Speyer: "OBGYN.net Weekly UPDATE" Maybe in reply to: Laurie Lovely: "Turner's mosaic/thrombocytopenia"

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