A TEENAGE GIRL WITH DELAYED PUBERTY AND HUMAN IMMUNODEFICIENCY VIRUS INFECTION (a case report)
Nunki Andria,Annang Giri Moelyo
Departement of Child Health Faculty of Medicine Sebelas Maret University Pediatric Endocrinology Subdivision Departement of Child Health Sebelas Maret University
Background : There is an association between HIV-infection and pubertal onset. Perinatally HIV-infected youth are less likely to have experienced puberty than their counterparts in the general population. Among HIV-infected girls, the absence of treatment was significantly related to delayed menarche.
Case Presentation Summary : A 16 year 4 month old girl came with amenorrhea. She complained for no breast enlargement, being short, recurrent diarrhea and fever. Her parents passed away due to AIDS. The physical examination revealed body weight 25 kgs, height 130 cms, white plaque in her mouth, pubertal status of M1P1. HIV rapid test was positive. Luteinizing hormone level was 0,11 mIU/mL. Ultrasonography demonstrated normal genitalia organ. Her bone age was in accordance with 13 year 6 month old. She has not received any antiretroviral therapy before. We administered Estradiol valerate to induce her puberty and Lamivudine, Tenofovir and Nevirapine for her antiretroviral therapy. Six months after Estradiol therapy, she experienced blood spotting and her pubertal status improved to be M2P2.
Learning Points/Discussion : Hormone therapy may induced puberty in HIV infected teenager with delayed puberty. In our case, the pubertal status improved along with gaining weight and height.
Keywords: delayed puberty HIV bone age pubertal status
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