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Ankylosing spondylitis complicating Turner syndrome: Two case reports and a literature review
Fang-Fei Chen1, Xue-Han Zhang2, Yang Jiao1
1Department of General Internal Medicine.
Rationale:
Turner syndrome (TS) is an anomaly caused by loss of part of or all the X chromosomes. Ankylosing spondylitis (AS) is an HLA-B27-associated autoimmune disease with a male predominance. It is widely accepted that TS patients are at higher risk of autoimmune diseases, but AS in TS patients has only rarely been reported.
Patient Concerns:
A 13-year-old TS patient presented with intermittent pain in both hip joints, and a 27-year-old TS patient presented with thoracic kyphosis and a history of AS.
Diagnoses:
Both patients were diagnosed with AS according to their symptoms, laboratory results, and imaging.
Interventions:
The first patient was treated with tocilizumab for 8 months, whereas the second patient was treated with diclofenac initially with subsequent surgery for thoracic kyphosis.
Outcomes:
Treatment relieved the symptoms of both patients and laboratory parameters improved.
Lessons:
Even though AS has a male predominance, clinicians should be aware that AS and TS may co-exist and that the clinical features are atypical in TS patients with AS.
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