Rare within Rare: A Girl with Severe Haemophilia A and Turner Syndrome

Author:

Blag Cristina1ORCID,Serban Margit2ORCID,Ursu Cristina Emilia2ORCID,Popa Cristina23,Traila Adina4,Jinca Cristian5,Tomuleasa Ciprian6ORCID,Bota Madalina1,Ionita Ioana7ORCID,Arghirescu Teodora Smaranda5

Affiliation:

1. Pediatric Discipline, Department of Mother and Child, Iuliu Hațieganu University of Medicine and Pharmacy, 400177 Cluj-Napoca, Romania

2. Onco-Hematology Research Unit, Romanian Academy of Medical Sciences, Children Emergency Hospital “Louis Turcanu” Timisoara, European Hemophilia Treatment Centre, 300011 Timisoara, Romania

3. Discipline of Genetics, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania

4. Medical Centre for Evaluation Therapy, Medical Education and Rehabilitation of Children and Young Adults, European Hemophilia Treatment Centre, 305100 Buzias, Romania

5. Department of Pediatrics, Division of Onco-Hematology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania

6. Department of Hematology, Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania

7. Department of Hematology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania

Abstract

A coincidental occurrence of severe haemophilia A and Turner syndrome in a female person is extremely rare (less than 10 cases published). In such challenging cases, a multidisciplinary approach based on medicine of precision with full access to genetic and bio-molecular exploration is indispensable. The article presents an eight-year-old girl, with a family history of haemophilia, without significant disease signs (only post-dental extraction bleeding and a shorter stature). Discordantly, however, the investigations revealed a challenging condition: a genotype of 46,X,i(Xq), with an Isochromosome Xq responsible for the Turner syndrome and simultaneously, for the detrimental transformation, interfering with X chromosome inactivation, of an obligate hemophilia carrier into a severe hemophilia case—two distinct and provocative diseases.

Publisher

MDPI AG

Subject

General Medicine

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