Poland’s Syndrome: Report of a Variant. CASE REPORT
A 12-year-old, secondary-school girl presented in June 2004 with flattening of the right anterior chest wall since birth. She also noticed underdevelopment of the right breast. She had about four episodes of spontaneous minor bleeding from the ipsilateral anterior chest wall within a period of six months before presentation. She is yet to attain menarche and witnessed no bleeding from other sites of the body. Her pregnancy, delivery and development were all uneventful. She is the fifth in a family of six girls; no family history of a similar disorder.
On examination (Figure 1), she was a young girl with sagging of the right shoulder, flattening of the right anterior chest wall, absent right anterior axillary fold and pectoralis major muscle, and underdevelopment of the right breast. There was no bony abnormality of the chest wall or limbs. She had appreciable strength and good range of right shoulder movement. The cardiorespiratory and abdominal examinations were not contributory. Medication you can afford skelaxin generic
Figure 1. Twelve-year-old girl with Poland’s syndrome. Note the small-sized breast absent axillary fold and the pectoralis major, all on the right side.
Radiological examination of the chest showed no bony or cardiac abnormalities. The pelvic and intraabdominal organs were normal sonographically. The packed cell volume, red cell count, prothrombin time (PT), prothrombin time with kaolin (PTTK), liver function tests and clotting time were normal; but the bleeding time was prolonged by three minutes against a control of 5 min on one occasion, and by 4.5 min against a control of 6 min on another. She had thrombocytopenia, with platelet count of 75xl0/liter on one occasion, and 74.5×1 OVliter on another. She was transfused with fresh, frozen plasma and was also commenced on physiotherapy to develop the compensatory muscles of the shoulder girdle and preserve their function. Posttransfusion platelet counts revealed a slightly sustained improvement, viz: 147 x lOVliter, 125xl0/liter and 125xl0/liter. Repeat liver function tests and clotting profiles were within normal limits, except the bleeding time, which consistently remained between 1-2.5 min above the control. She is, however, free of any bleeding episodes 10 months after treatment and now awaits latissimus dorsi flap reconstruction of the right chest wall, which she has chosen to undertake in three years, after her secondary education. When you can’t afford your medication buy online imitrex migraine