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Anorexia nerviosa en una paciente con síndrome de Turner
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Paretas" "autores" => array:6 [ 0 => array:3 [ "nombre" => "G." "apellidos" => "Perkal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Hollemberg" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "M.J." "apellidos" => "Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "C." "apellidos" => "Lombardía" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff3" ] ] ] 4 => array:3 [ "nombre" => "L.G." 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España" "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff3" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La anorexia nerviosa (AN) y el síndrome de Turner (ST) son las dos causas más frecuentes de hipogonadismo y osteopenia.</p><p class="elsevierStyleSimplePara elsevierViewall">¿Qué ocurre con la densidad mineral ósea (DMO) en una paciente en la que concurren ambas patologías?</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Paciente de 17 años, diagnosticada de ST a los 4 años de edad, quien desarrolla un trastorno de conducta alimentaria (TCA) caracterizado por restricción alimentaria e hiperactividad física compulsiva. Antecedentes personales: adenoidectomía y drenajes transtimpánicos a los 4 años; ST tratado con hormona de crecimiento (GH) de los 5 a los 11 años; menarca espontánea a los 11 años; tratamiento con estradiol en parches de 50 μg más medrogestona 5 mg/día desde los 12 años. Antecedentes familiares: abuela materna con depresión y tentativas de suicidio. Hermano con trastorno por déficit de atención e hiperactividad. Enfermedad actual: se inicia hace 12 meses con una pérdida ponderal de 11,600 kg, pasando de un índice de masa corporal (IMC) previo de 26 al actual de 20. Mantiene menstruaciones inducidas por el tratamiento hormonal. Ingresa en hospital de día de TCA y, a los 4 meses, se decide su ingreso hospitalario por persistencia del descenso ponderal y nula conciencia de enfermedad. Se agrega a la pauta fluoxetina, 40 mg/día y lorazepam y se cambia el tratamiento hormonal por un anovulatorio con gestodeno y etinilestradiol. Exámenes complementarios: analítica sanguínea: destaca un descenso de inmunoglobulinas y transferrina y un discreto aumento del colesterol. LH: 0,64 mU/ml; FSH: 15,67 mU/ml; 17 β-estradiol: 142,6 pg/ml. Densitometría ósea: normal.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Es dada de alta con una recuperación ponderal de 4,500 kg y continúa actualmente el tratamiento en hospital de día.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">En esta paciente, el haber presentado una menarca espontánea e introducir posteriormente el tratamiento hormonal compensatorio, permitió mantener una DMO dentro de la normalidad a pesar del descenso ponderal y del hipogonadismo derivado de sus dos patologías.</p>" ] ] ] "idiomaDefecto" => "es" "url" => "/16954033/0000006600000002/v2_201308271339/S1695403307703442/v2_201308271339/es/main.assets" "Apartado" => array:4 [ "identificador" => "14291" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Secciones de la A.E.P." 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