Sunday, April 17, 2011

Turner Syndrome



Definition: Genetic condition in which a female does not have the usual pair of two X chromosomes. The condition only occurs in females. Most commonly, the female patient has only one X chromosome – “monosomy X”. Others may have two X chromosomes, but one of them is incomplete. In some cases, the chromosome is missing in some cells but not others “mosaicism”.

Etiology: Genetic mosaicism (46XX/45XO), nondisjunction (45XO), and partial monosomy (46XX). During conception, part of all of the second sex chromosome is not transferred to the fetus.

Frequency: 1:2000

Clinical features:

Possible symptoms in young infants:

- Lymphedema: swollen hands and feet

- wide and webbed neck

Possible general symptoms:

- short height

- increased weight, obesity

- absent or incomplete development at puberty

o sparse pubic hair and small breasts

- broad, flat chest shaped like a shield “shield chest”

- drooping eyelids

- dry eyes

- low hairline

- low-set ears

- infertility

- absent menstruation

- vaginal dryness, can lead to painful intercourse

Oral features:

- micrognathia: small lower jaw

- high-arched palate

Treatment:

Short height -> Growth Hormone

Lack of development of sexual characteristics -> Estrogen

Infertility -> Donor Egg

Concurrent Complications:

- congenital heart disease and other cardiac problems

- horseshoe kidney

- hypothyroidism

- diabetes

- vision problems

- hearing problems

- autoimmune diseases

- ADHD

- cognitive deficits (visuospatial, mathematical, and memory areas)

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