Diagnostic Dilemma - Pediatric Oncall
Short stature
Author: Naji Ahmed
A 14 years old girl presented with short stature. Weight is 44kg {25th centile}, length is 144cm {below 3rd centile}. Past medical history reveals affection with alopecia and vitiligo for which she received lengthy courses of steroid. Now she is off steroids. She has dysmenorrhea. Thyroid function tests are normal. There is no anemia and renal function tests are normal. LH is 1ml U, ml, FSH is 2.4ml U, ml, Prolactin is 9ng, ml, Progesterone is 4nmol, l, and estradiol is 128pmol, l. No clinical evidence of Turners syndrome. Ultrasound shows follicular cyst in left ovary. Uterus and right ovary is normal. Bone age is depicted in figure 1.
Answers of this discussion
Author :- ravi agrawal on 25 April 2012.
Answer :- magnesium status to be checked.

Author :- sree harsha on 29 April 2012.
Answer :- looks like autoimmune polyglandular syndrome type 3

Author :- serdarcash on 04 May 2012.
Answer :- turner syndrome has increase suceptebility to autoimmune disease even if there is no clinical evidence send for chromosomal analyesis

Author :- zaki mokbel on 05 May 2012.
Answer :- adrenal harmon assay

Author :- hassan siddik on 07 May 2012.
Answer :- rickets dependent type 2

Author :- sameercash on 13 May 2012.
Answer :- i think excess extradiol is from the follicular cyst causing suppression of fsh lh so anti estrogen treatment might be considerded and chromosomal ananlysisi is necessaryu

Author :- jincy joyca on 19 May 2012.
Answer :- autoimmune

Author :- Edsel Peter on 26 May 2012.
Answer :- check her bone age and sos growth hormone levels

Author :- Ahmed Abdulla on 26 May 2012.
Answer :- Long term use of steroids can suppress her GH Also having alopecia increase her risk for other autoimmune thyroiditis

Author :- nael dahleh on 26 May 2012.
Answer :- rickets

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