OBJECTIVE Adult patients with Turner's syndrome are rarely followed up
at specialist clinics after discharge from paediatric care but do hav
e a predisposition to several long-term medical problems. We have asse
ssed the undiagnosed morbidity that exists among adult women with Turn
er's syndrome. PATIENTS A group of 32 women (age range 17-52 years; me
an 25 years) attending a specialist out-patient clinic. MEASUREMENTS B
lood samples were obtained at the initial visit for lipid assessment,
thyroid function, gonadal status and routine biochemical profile. Bone
mineral density (BMD) was measured in 31 of the women. RESULTS Thirty
-one women were receiving some form of oestrogen replacement. Two were
receiving T4 therapy. In 50%, total cholesterol was greater than 5.2
mmol/l (range 3.4-9.3 mmol/l, mean 5.8 mmol/l) and 28% had an abnormal
ity of thyroid function tests. Two women were newly diagnosed as hypot
hyroid, 6 had compensated hypothyroidism and one was under-replaced wi
th T4. Lumbar spine BMD was below 100% of age matched reference range
in 84% and below 75% in 26% of patients. Femoral neck BMD was below 10
0% of age matched reference range in 90% and below 75% in 10% of patie
nts. CONCLUSIONS There is a high incidence of undiagnosed lipid, thyro
id and bone mineral density abnormalities in the adult population with
Turner's syndrome. Doctors caring for these women need to be aware of
and look for the potential problems. Appropriate long-term treatment
should be commenced to help prevent the development of lipid, skeletal
and thyroid abnormalities which may cause these patients major proble
ms in the future.