Management of Turner syndrome in adult life and beyond

• Dysmorphology may be correlated with congenital cardiovascular defects.
• The age for initiation and duration of GH treatment in TS are controversial.
• Height, age, dysmorphology, estrogen use, and hearing loss may affect sexuality.
• Proposals for the management of TS in adult life and insight into the medical complaints are provided.
• Prenatal diagnosis allows prediction of ovarian failure and cryopreservation in selected patients.

ObjectiveTo describe in practical terms the clinical management in adult life of patients with Turner syndrome.Material & methodsSystematic review of the literature and practical issues. An evaluation of clinical trials, meta-analysis, case reports and reviews assessing the management of different conditions related to Turner syndrome was done using the following data sources: Medline, PubMed (from 1966 to July 2014) and the Cochrane Controlled Clinical Trials Register, Embase (up to July 2014).ResultsExtracted information is summarized here on karyotype, screening of malformations, malformations debuting in adult life, final height, treatments with growth hormone, cardiovascular risk, endocrino-metabolic and liver abnormalities, sensorineural disorders and osteoporosis and its treatment.ConclusionsThis review provides recommendations for the management of adult patients with Turner syndrome and insight into the associated medical complaints. A link between karyotypes and clinical features suggests a novel hypothesis to explain the different phenotypes and clinical abnormalities of these patients.