Severe anorexia nervosa in an adolescent girl with Turner syndrome: A case report with psychosocial implications.

BACKGROUND: Adolescence is a critical period for the development of body image and self-evaluation. Turner syndrome (TS) is characterized by short stature and delayed or absent secondary sexual development, which may become particularly salient during adolescence. However, the association between TS and anorexia nervosa (AN) remains unclear. We report a case of severe AN in an adolescent girl with TS. CASE PRESENTATION: A 16-year-old girl diagnosed with TS in early childhood had received regular pediatric follow-up. During junior high school, she became increasingly conscious of physical and pubertal differences between herself and her peers and experienced confusion and distress regarding bodily changes after initiation of Kaufmann therapy. After entering high school, she began restricting her dietary intake following a peer's comment that her neck appeared thick. Over 6 months, her weight decreased by approximately 10-28.5 kg (body mass index, 13.6 kg/m2). Despite severe underweight, she expressed an intense fear of weight gain and persistently perceived herself as overweight. She was diagnosed with AN. Nutritional rehabilitation, psychoeducation, and cognitive interventions targeting body-related concerns and negative automatic thoughts were provided. Her body weight increased to 33.6 kg (body mass index, 16.0 kg/m2), and she was discharged on day 91. Her weight remained stable for 18 months. CONCLUSION: This case illustrates that AN in an adolescent with TS may present with typical AN psychopathology, while experiences related to physical and pubertal development may constitute an important part of the individual psychosocial context. Clinicians should assess these experiences alongside core AN psychopathology and incorporate them into standard treatment and individualized psychosocial support.