临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (4): 298-.doi: 10.3969/j.issn.1000-3606.2021.04.015

• 罕见病 疑难病 • 上一篇    下一篇

快进展型青春期威廉姆斯综合征女童1 例GnRHa 治疗分析

姜丽红, 鲍鹏丽, 郑荣秀, 刘戈力   

  1. 天津医科大学总医院儿科(天津 300052)
  • 发布日期:2021-04-15
  • 通讯作者: 刘戈力 电子信箱:liugeli 2001 @ 126 .com

Rapidly progressive puberty in a girl with Williams syndrome and follow-up for GnRHa treatment

JIANG Lihong, BAO Pengli, ZHENG Rongxiu, LIU Geli   

  1. Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin 300052 , China
  • Published:2021-04-15

摘要: 目的 探讨威廉姆斯综合征(WBS)患儿性早熟的治疗。方法 回顾分析1例快进展型青春期WBS女童的临 床资料,并复习相关文献。结果 女性患儿,9岁5个月,因乳腺发育1年余、月经来潮3次就诊。根据患儿特殊面容、主动 脉瓣上狭窄、智能发育落后、性早熟及医学外显子测序,WBS诊断明确。患儿骨龄提前2岁,子宫长径37 mm,内膜5 mm, 双侧卵巢均有数个>4 mm的卵泡,卵巢容积3~4 mL,随机促黄体生成素(LH)3.43mIU/mL,骨龄身高SDS 为-1 . 92, 符合快进展型青春期的诊断标准,给予促性腺激素释放激素类似物(GnRHa)治疗。治疗1年后复查,患儿性激素处于青 春期前水平,年身高增长速率5. 3 cm,骨龄身高SDS为-1 . 55。结论 WBS患儿可出现性早熟(快进展型青春期),应用 GnRHa干预可改善患儿成年终身高,同时缓解家长的焦虑。

关键词: 威廉姆斯综合征; 快进展; 性早熟; 促性腺激素释放激素类似物

Abstract: Objective To explore the treatment of precocious puberty in girls with Williams syndrome (WBS). Methods The clinical data of rapidly progressive puberty in a girl with WBS were retrospectively analyzed, and the relevant literature was reviewed. Results A 9 years and 5 months old girl was brought to clinic due to breast development for more than one year and menstruation for three times. According to the special facial features, supraaortic stenosis, mental retardation, precocious puberty and medical exon sequencing results, the diagnosis of WBS was confirmed. The child met the diagnostic criteria of rapidly progressive puberty because the bone age of the child was 2 years older than her chronologic age, the uterine length was 37 mm, the endometrium was 5 mm, the bilateral ovaries had several follicles larger than 4 mm, the ovarian volume was 3 - 4 mL, the random level of luteinizing hormone (LH) was 3 . 43 mIU/mL, and the bone age height SDS was - 1 . 92 , and was treated with GnRHa. Reexamination after 1 year of treatment showed that the child’s sex hormones were at prepubertal level, the annual height growth rate was 5 . 3 cm, and the height SDS of bone age was - 1 . 55 . Conclusions Children with WBS may have precocious puberty (rapidly progressive puberty). The application of GnRHa intervention can improve the adult height in children with WBS and relieve the anxiety of parents.

Key words: Williams syndrome; rapid progression; precocious puberty; GnRHa