Klinefelters Syndrome Amy Batley Feb 2012
Dr Harry Klinefelter Jnr 1942 Massachusetts Described men –TALL –HYPOGONADISM –NO SPERM –SPARSE HAIR –GYNAECOMASTIA
Epidemiology Most common sex chromosome disorder Approx 1.7/1000 male births All ethnicity
Genetics Normally 46 XY (Man) In Klinefelters mainly an xtra X (47XXY) But variations occur 48 XXYY, mosaic- 47XXY/46XY
Presentation PRESENTATION Delayed speech Learning difficulties (varying) Truncal obesityHypogonadism Subfertility / impotence Failure of sexual maturation Rapid growth mid childhood Gynaecomastia
Features
features Loss of libido, Reduced power and muscle strength Tiredness Osteoporosis Depression At risk heart disease
Investigations Serum testosterone is low /low normal Fsh and lh are raised Chromosomal analysis to confirm
Associations hypothyroid Insulin resistance Germ cell tumours PSYCHSpeech dely Breast cancer x50 Lung diseas
Management Endocrine/genetics/psychologist/ Speech therapist Testosterone replacement (just prior to puberty) Breast education Fertility treatment ICSI AID Plastic - gynaecomastia
Prognosis Lifespan is normal
Kallmann syndrome Kallmann Syndrome: A rare inherited condition hypogonadism, eunuchoidism impaired or absent sense of smell. failure of a part of the hypothalamus which results in hormonal imbalance.
Marfans connective tissue disorder tall stature, elongated extremities, subluxation of the lens, dilatation of the ascending aorta "pigeon breast." autosomal dominant
Hypopituitary reduced pituitary hormone levels. growth hormones prolactin TSH ADH
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