Turner Syndrome Associated with Ulcerative Colitis

We report the case of a 7-yr-old girl with Turner syndrome, ulcerative colitis (UC) andcoarctation 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 tracesof 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 enemashowed aphtha and loss of the fine network pattern in the descending colon and rectum. Anendoscopic examination showed ulceration, edema, friability, and erythema beginning in therectum and extending up to the splenic flexure of the descending colon. The histology ofthe descending colon area showed severe stromal infiltration of inflammatory cells. Theseendoscopic findings and the histological findings were consistent with UC. Thus, based onthese findings, the patient was diagnosed as having UC. Mesalazine therapy was initiatedat this time. The patient is currently being treated with mesalazine (1,000 mg/day) andabdominal symptoms and bloody diarrhea have disappeared. GH therapy was not interruptedduring the therapy for UC. Retrospectively, growth hormone improved growth velocity (9cm/year) during the first year of treatment, however from the age of 4 yr, growth velocitydecreased (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.