Ankylosing spondylitis complicating Turner syndrome: Two case reports and a literature review.
RATIONALE
Turner syndrome (TS) is an anomaly caused by loss of part of or all the X chromosomes. Ankylosing spondylitis (AS) is an HLA-B27-associated autoimmune disease with a male predominance. It is widely accepted that TS patients are at higher risk of autoimmune diseases, but AS in TS patients has only rarely been reported.


PATIENT CONCERNS
A 13-year-old TS patient presented with intermittent pain in both hip joints, and a 27-year-old TS patient presented with thoracic kyphosis and a history of AS.


DIAGNOSES
Both patients were diagnosed with AS according to their symptoms, laboratory results, and imaging.


INTERVENTIONS
The first patient was treated with tocilizumab for 8 months, whereas the second patient was treated with diclofenac initially with subsequent surgery for thoracic kyphosis.


OUTCOMES
Treatment relieved the symptoms of both patients and laboratory parameters improved.


LESSONS
Even though AS has a male predominance, clinicians should be aware that AS and TS may co-exist and that the clinical features are atypical in TS patients with AS.