Hiploplasia Uterus Dengan Amenorea Primer Pada Sindroma Turner: Laporan Kasus

Rajuddin Rajuddin, Sarjani Sarjani, Hilwah Nora

Abstract


Amenorea merupakan kondisi yang ditandai dengan ketidakadaan periode[PS1] [PS2]  menstruasi pada perempuan usia reproduksi. Kondisi ini terjadi akibat adanya kegagalan perkembangan alat reproduksi seperti ketidakadaan rahim, kegagalan ovarium serta anomali urogenital seperti kelainan duktus Mullerian. Diagnosis yang akurat sangat menentukan manajemen yang tepat dan optimal dalam penatalaksanaan. Laporan kasus ini bertujuan untuk menjelaskan mengenai pendekatan diagnostik serta tatalaksana amenorea primer terkait sindroma turner. Studi kasus ini menggunakan metode pendekatan prospektif sehingga dapat mencapai diagnosis terbaik. Didapatkan hasil seorang perempuan, usia 22 tahun, belum pernah mengalami haid sampai usia 21 tahun. Pasien pertama kali haid dengan durasi 6 hari setelah mengkonsumsi obat yang mengandung kombinasi Estradiol valerat dan Norgestrel pada bulan November 2019. Setelah berhenti minum obat selama 3 bulan, pasien tidak mengalami menstruasi dan siklus menstruasi tidak teratur lagi. Pemeriksaan status generalisata dalam batas normal. Pemeriksaan  tanda seks sekunder didapatkan tanner stage M2P2.  Pemeriksaan ultrasonografi menunjukkan uterus berukuran kecil dengan ovarium kiri sulit dinilai dengan kesan hipoplasia uterus. Pemeriksaan laboratorium didapatkan kadar hormon tiroid FT4: 18,59 ng/dL, TSHs: 5,9 ng/dL, Anti mullerian hormon (AMH): <0,01 ng/mL, FSH: 102,11 mIU/mL, dan estradiol: <9 pg/dL. Hasil pemeriksaan kromosom didapatkan kariotipe 45X dengan kehilangan satu kromosom seks X.  Pasien dengan sindroma Turner klasik yang mengalami kelainan kromosom seks 45X hipoplasia uterus dengan hipergonadotropik dan hipogonadisme serta hipotiroidisme, dibutuhkan tatalakasana yang tepat dengan pendekatan menyeluruh dan pendekatan psikososial

 [PS1]

 [PS2]


Keywords


Amenorea primer, hipogonadisme, hipergonadotropik, kelainan kongenital, Turner.

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References


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DOI: http://dx.doi.org/10.30596%2Fjih.v2i2.10133

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