Endocrine Abstracts (2017) 50 CMW5.3 | DOI: 10.1530/endoabs.50.CMW5.3

How do I ... approach CVS surveillance in a patient with Turner Syndrome

Claus H Gravholt


Aarhus University Hospital, Aarhus, Denmark.


New international clinical guidelines have just been published, based on an international effort that started with exploratory meetings in 2014 in both Europe and the USA, and culminated with a Consensus Meeting held in Cincinnati, Ohio, USA in July 2016. These guidelines were initiated and developed by ESE in Europe, and by PES in USA, with important contributions from ESHRE, Endocrine Society, ESC, AHA, Society for Endocrinology, and ESPE.

Morbidity and mortality is increased in TS, especially due to the risk of dissection of the aorta and other cardiovascular diseases, as well as the risk of type 2 diabetes, hypertension, osteoporosis, thyroid disease and other diseases.

During the transition period many young females opt out of longitudinal follow-up, probably because they feel well and cannot clearly see the need for continued medical surveillance. However, osteoporosis, diabetes, both type 1 and 2, hypothyroidism, obesity and a host of other endocrinological diseases and conditions are seen more frequently in Turner syndrome in the long term. Hypertension is frequent and can be a forerunner of cardiovascular disease. Congenital cardiovascular malformations are very frequently seen among females with TS and the introduction of imaging techniques such as MRI or CT are necessary in order to enhance care for TS. Clinical follow-up should be individually tailored depending on the morbidity burden. Prevention, intervention and proper treatment is only just being recognized.

The description of adult life with Turner syndrome has been broadened and medical, social and psychological aspects are being added at a compelling pace.

Proper care during adulthood should be optimized and a framework for care should be in place, since most morbidity potentially is amenable to intervention.

In summary, Turner syndrome is a condition associated with a number of diseases and conditions which need the attention of a multi-disciplinary team during adulthood.

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