Представлен клинический случай задержки полового развития у 13-летней девочки с анемией Фанкони, направленной в отделение гинекологии детей и подростков ФГБУ «НМИЦ АГП им. акад. В.И. Кулакова» для удаления половых желез в связи с обнаружением при обследовании по месту жительства Y-хромосомы в кариотипе. Персонифицированный мультидисциплинарный подход к ведению пациентки с анемией Фанкони и наличием Y-хромосомы в кариотипе на фоне задержки полового развития позволил выявить ятрогенный химеризм и избежать необоснованной кастрации 13-летней девочки.
The article presents a clinical case of delayed puberty in a 13-year-old girl with Fanconi anemia who was sent to the Department of gynecology of children and adolescents for removal of the sexual glands due to the detection of a Y-chromosome in the karyotype at the place of residence. A personalized multidisciplinary approach to the management of a patient with Fanconi anemia with the presence of the Y-chromosome in the karyotype against the background of delayed puberty allowed to identify iatrogenic chimerism and avoid unjustified castration.
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2. Shimamura A, Alter BP. Pathophysiology and management of inherited bone marrow failure syndromes. Blood Rev 2010; 24 (3): 101–22.
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4. Rodriguez A, D'Andrea A. Fanconi anemia pathway. Curr Biol 2017; 27 (18): R986-r8.
5. McCann S, Lawler M. Mixed chimerism; detection and significance following BMT. Bone Marrow Translant 1993; 11: 91–4.
6. Tippet P. Blood group chimeras: A review. Vox Sang 1983; 44: 333–59.
7. Bader P, Niethammer D, Willasch A et al. How and when should we monitor chimerism after allogeneic stem cell transplantation? Bone Marrow Transplant 2005; 35 (2): 107–19.
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1. Fiesco-Roa MO, Giri N, McReynolds LJ et al. Genotypephenotype associations in Fanconi anemia: A literature review. Blood Rev 2019; 37. https://doi.org/10.1016/j.blre.2019.100589
2. Shimamura A, Alter BP. Pathophysiology and management of inherited bone marrow failure syndromes. Blood Rev 2010; 24 (3): 101–22.
3. Alter BP, Giri N, Savage SA, Rosenberg PS. Cancer in the National Cancer Institute inherited bone marrow failure syndrome cohort after fifteen years of follow-up. Haematologica 2018; 103 (1): 30–9.
4. Rodriguez A, D'Andrea A. Fanconi anemia pathway. Curr Biol 2017; 27 (18): R986-r8.
5. McCann S, Lawler M. Mixed chimerism; detection and significance following BMT. Bone Marrow Translant 1993; 11: 91–4.
6. Tippet P. Blood group chimeras: A review. Vox Sang 1983; 44: 333–59.
7. Bader P, Niethammer D, Willasch A et al. How and when should we monitor chimerism after allogeneic stem cell transplantation? Bone Marrow Transplant 2005; 35 (2): 107–19.
ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России, Москва, Россия
*zai-kumykova@yandex.ru
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Zaira Kh. Kumykova*, Irina A. Kiseleva, Zalina K. Batyrova, Olga A. Buyanovskaya
Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
*zai-kumykova@yandex.ru