title: Increased liver enzymes and hormonal therapies in girls and adolescents with Turner syndrome.
abstract: Elevated liver enzymes can be seen relatively frequently in patients with Turner syndrome (TS), while the pathogenesis of this remains unclear. Our epidemiological and prospective study aimed to investigate: a) the natural 2-yr course of liver disease in a selected cohort of young patients with TS, who had been preliminarily recruited on the basis of persistently elevated liver enzymes; b) the role of prolonged hormonal therapies in the etiology of liver dysfunction. From an overall population of 214 TS patients younger than 20 yr, only 19 (8.9%) were recruited, according to the following inclusion criteria: increased serum concentrations of one or more liver enzymes, exceeding the uppermost limit of the respective normal ranges, and persistence of these liver alterations for 6 months after the preliminary assessment. On the basis of the results of this prospective study, we can conclude that: a) the prevalence of liver abnormalities in girls and adolescents with TS is much lower and more strictly related to hormonal therapies than in TS adults; b) both autoimmunity and obesity are not frequently involved in the etiology of TS liver dysfunction; c) liver damage is either mild or moderate and its severity is not conditioned by karyotype; d) its course may be self-limiting; e) its natural history may be characterized in some cases by a slight deterioration of intrahepatic cholestasis, with no negative repercussions on liver synthetic function.
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy. wasniewska@yahoo.it
authors.forename: M
authors.initials: M
authors.lastname: Wasniewska
authors.forename: R
authors.initials: R
authors.lastname: Bergamaschi
authors.forename: P
authors.initials: P
authors.lastname: Matarazzo
authors.forename: B
authors.initials: B
authors.lastname: Predieri
authors.forename: S
authors.initials: S
authors.lastname: Bertelloni
authors.forename: A
authors.initials: A
authors.lastname: Petri
authors.forename: M
authors.initials: M
authors.lastname: Sposito
authors.forename: M F
authors.initials: MF
authors.lastname: Messina
authors.forename: F
authors.initials: F
authors.lastname: De Luca
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D015331:Cohort Studies; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000201:enzymology* / Q000235:genetics; D008137:Longitudinal Studies; D011446:Prospective Studies; D014424:Turner Syndrome / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology* / Q000235:genetics; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D019382:Human Growth Hormone; D004997:Ethinyl Estradiol; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase