Endocrine Abstracts

Women with Turner Syndrome should be followed up at a dedicated clinic which provides multidisciplinary input to offer holistic care. Any young person who has been under the care of a specialised paediatric clinic since early childhood will be anxious about the transition to adult services, and this is particularly so for girls with Turner Syndrome. A consultant-based clinic with familiar staff provides reassurance that one person or team is aware of their health needs and can co-ordinate their care. This is usually in the setting of a general endocrinology, specialist gynae endocrinology or menopause clinic. Caring for these young women includes finding a form of suitable HRT to suit individual needs, monitoring blood pressure, thyroid function, liver function and screening for type 2 diabetes. Bone density should be monitored by DEXA scan and lifestyle advice given regarding bone health. If bone density is low, oestradiol levels are useful in assessing compliance with HRT and confirming adequate absorption of oestrogen, while Vitamin D deficiency should also be considered. Due to the high incidence of deranged liver enzymes in women with Turner syndrome, links need to be established with a specialist hepatology clinic. Input from a specialist inherited cardiac disease clinic is also essential with regular follow up for those with previously diagnosed cardiac abnormalities and 5 yearly follow up including cardiac MRI & ECHO even for those with no previously diagnosed abnormalities. This is particularly important for women with Turner Syndrome who wish to pursue assisted conception, who should be advised to discuss any plans for fertility treatment with the doctor who co-ordinates their overall care.