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    Turner syndrome

    Bonnevie-Ullrich syndrome; Gonadal dysgenesis; Monosomy X

    Turner syndrome is a genetic condition in which a female does not have the usual pair of two X chromosomes.

    Causes

    The normal amount of human chromosomes is 46. Chromosomes contain all of your genes and DNA, the building blocks of the body. Two of these chromosomes, the sex chromosomes, determine if you become a boy or a girl. Females normally have two of the same sex chromosomes, written as XX. Males have an X and a Y chromosome (written as XY).

    In Turner syndrome, cells are missing all or part of an X chromosome. The condition only occurs in females. Most commonly, the female patient has only one X chromosome. Others may have two X chromosomes, but one of them is incomplete. Sometimes, a female has some cells with two X chromosomes, but other cells have only one.

    Turner syndrome occurs in about 1 out of 2,000 live births.

    Symptoms

    Possible symptoms in young infants include:

    • Swollen hands and feet
    • Wide and webbed neck

    A combination of the following symptoms may be seen in older females:

    • Absent or incomplete development at puberty, including sparse pubic hair and small breasts
    • Broad, flat chest shaped like a shield
    • Drooping eyelids
    • Dry eyes
    • Infertility
    • No periods (absent menstruation)
    • Short height
    • Vaginal dryness, can lead to painful intercourse

    Exams and Tests

    Turner syndrome can be diagnosed at any stage of life. It may be diagnosed before birth if a chromosome analysis is done during prenatal testing.

    The doctor will perform a physical exam and look for signs of poor development. Infants with Turner syndrome often have swollen hands and feet.

    The following tests may be performed:

    • Blood hormone levels (luteinizing hormone and follicle stimulating hormone)
    • Echocardiogram
    • Karyotyping
    • MRI of the chest
    • Ultrasound of reproductive organs and kidneys
    • Pelvic exam

    Turner syndrome may also change estrogen levels in the blood and urine.

    Treatment

    Growth hormone may help a child with Turner syndrome grow taller. Estrogen replacement therapy is often started when the girl is 12 or 13 years old. This helps trigger the growth of breasts, pubic hair, and other sexual characteristics.

    Women with Turner syndrome who wish to become pregnant may consider using a donor egg.

    Support Groups

    For additional information and resources, see:

    Turner Syndrome Society -- www.turnersyndrome.org

    Outlook (Prognosis)

    Those with Turner syndrome can have a normal life when carefully monitored by their doctor.

    Possible Complications

    • Abnormal aortic valve or narrowing of the aorta in an infant, and widening of the aortain an adult
    • Arthritis
    • Cataracts
    • Diabetes
    • Hashimoto's thyroiditis
    • Heart defects
    • High blood pressure
    • Kidney problems
    • Middle ear infections
    • Obesity
    • Scoliosis (in adolescence)

    Prevention

    There is no known way to prevent Turner syndrome.

    References

    Morgan T. Turner syndrome: diagnosis and management. Am Fam Physician. 2007;76:405-410.

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                  Review Date: 3/30/2012

                  Reviewed By: A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Chad Haldeman-Englert, MD, Wake Forest School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network (11/14/2011).

                  The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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