Format

Send to

Choose Destination
J Clin Res Pediatr Endocrinol. 2018 Jul 31;10(3):230-238. doi: 10.4274/jcrpe.0003. Epub 2018 Apr 27.

A Synopsis of Current Practice in the Diagnosis and Management of Patients with Turner Syndrome in Turkey: A Survey of 18 Pediatric Endocrinology Centers

Author information

1
University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Pediatric Endocrinology and Diabetes, İstanbul, Turkey
2
Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, Turkey
3
Süleyman Demirel University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Isparta, Turkey
4
İzmir Katip Çelebi University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, İzmir, Turkey
5
Trakya University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Edirne, Turkey
6
Adnan Menderes University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Aydın, Turkey
7
Gazi University Faculty of Medicine, Department of Pediatric Endocrinology and Diabetes, Ankara
8
Private practice

Abstract

Objective:

A comprehensive survey was conducted to evaluate the shortcomings of clinical care in patients with Turner syndrome (TS) in Turkey.

Methods:

A structured questionnaire prepared by the Turner study group in Turkey, which covered relevant aspects of patient care in TS was sent to 44 pediatric endocrinology centers.

Results:

Eighteen centers (41%) responded to the questionnaire. In the majority of the centers, diagnostic genetic testing, screening for Y chromosomal material, protocols regarding the timing and posology of growth hormone (GH) and estrogen, thrombophilia screening, fertility information and screening for glucose intolerance, thyroid, and coeliac diseases in patients with TS were in line with the current consensus. Thirteen centers (72.2%) performed GH stimulation tests. Only four centers (22.2%) used oxandrolone in patients with TS with very short stature. The majority of the centers relied on bone age and breast development to assess estrogen adequacy, though together with variable combinations of oestrogen surrogates. Two centers (11.1%) reported performing serum estradiol measurements. Eight centers (44.4%) routinely conducted cardiac/thoracic aorta magnetic resonance imaging. Screening for hearing, dental and ophthalmologic problems were performed by thirteen (72.2%), six (33.3%) and ten (55.6%) centers, respectively. Psychiatric assessments were made by four centers (22.2%) at diagnosis, with only one center (5.6%) requiring annual reassessments.

Conclusion:

Although we found some conformity between the current consensus and practice of the participating centers in Turkey regarding TS, further improvements are mandatory in the multi-disciplinary approach to address co-morbidities, which if unrecognized, may be associated with reduced quality of life and even mortality.

KEYWORDS:

Turner syndrome; diagnosis; growth; puberty; oestrogen; oxandrolone; osteoporosis; adult transition; screening; cardiac magnetic resonance imaging; thoracic aorta

PMID:
29699389
PMCID:
PMC6083465
DOI:
10.4274/jcrpe.0003
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Galenos Yayinevi Icon for PubMed Central
Loading ...
Support Center