title: Health management of adults with Turner syndrome: an attempt at multidisciplinary medical care by gynecologists in cooperation with specialists from other fields.
abstract: OBJECTIVE
  Since women with Turner Syndrome (TS) have various complications, they require comprehensive medical evaluation and multidisciplinary treatment. Although TS patients receive adequate care in childhood, many adults with TS do not. Since most TS adults attend gynecologists for hormone replacement therapy, we suggest gynecologists take primary responsibility for their management. In an attempt to provide TS patients with a comprehensive treatment regimen, we started multidisciplinary medical management in the Reproductive Health Clinic at Yokohama City University Hospital. To evaluate the efficacy of this medical care system, a retrospective analysis was conducted.
  
  
  METHODS
  The clinical profiles of 57 TS patients were examined. The past histories, complications and clinical data of these patients were extracted from their medical records and examined clinically. Bone mineral density measurements of lumbar vertebrae (L(2-4)), anti-thyroid antibody titer measurements, hearing tests and cardiovascular MRI were also performed.
  
  
  RESULTS
  Mean follow-up duration was 5.1 years (range, 1-8 years). At the time of transition, patients with complications developed in childhood, such as amenorrhea, osteopenia/osteoporosis, otitis media, thyroid dysfunction and cardiovascular disease were identified. All these complaints were successfully followed up in our adult care system. Several complications common to TS adults, such as glucose intolerance, liver dysfunction, hyperlypidemia and hypertension could be identified by our screening system. Patients were referred to specialists when necessary.
  
  
  CONCLUSIONS
  Multidisciplinary health management in our Reproductive Health Clinic improved the status of medical care for TS adults.
authors.affiliation: Department of Obstetrics and Gynecology, Yokohama City University, School of Medicine, Kanazawa, Japan. hideya1@aol.com
authors.forename: Hideya
authors.initials: H
authors.lastname: Sakakibara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Maki
authors.initials: M
authors.lastname: Takei
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Katsuhata
authors.forename: Makiko
authors.initials: M
authors.lastname: Koyama
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nagata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Fumiki
authors.initials: F
authors.lastname: Hirahara
mesh_terms: D000293:Adolescent; D000328:Adult; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006176:Gynecology; D006801:Humans; D007564:Japan; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult