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Transition Considerations for Turner Syndrome

  • Sarah D. CorathersEmail author
  • Melissa Gerstle
  • Lori A. Casnellie
  • Colleen Pater
  • Gylynthia Trotman
Chapter

Abstract

Turner syndrome is a common chromosomal abnormality with lifelong complex medical considerations. In childhood, pediatric endocrinologists often play a leading role in care coordination due to hormone interventions related to growth and puberty induction. As girls with Turner syndrome grow older, there is risk for loss to follow-up in adult care; however, medical and psychosocial needs are lifelong. Based upon neurocognitive and social features, women with Turner syndrome may reside in parental homes and take longer to establish independence than peers without Turner syndrome. Preparation for transition between pediatric and adult health systems therefore requires thoughtful development of health navigation skills, knowledge of personal health history, awareness of indications for ongoing adult prevention and screening for common coexisting conditions associated with Turner syndrome, and psychosocial supports. Adult endocrinologist may serve as a consultative role to perform annual comprehensive evaluation of medical needs and services. Endocrinologists may oversee management of estrogen replacement, bone health, blood pressure surveillance and treatment, and metabolic and autoimmune health screenings. In addition, adult endocrinologists and primary care providers can both help coordinate relevant care with other specialties as indicated. Special attention is given in the chapter to considerations around cardiovascular health, gynecology and fertility, neurocognitive concerns, as well as the role of a Turner syndrome clinic coordinator and value of peer support systems, advocacy groups, and social networking during transition.

Keywords

Turner syndrome Transition to adult care Psychosocial health Premature ovarian insufficiency Cardiovascular health Healthcare navigation Care guidelines 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sarah D. Corathers
    • 1
    • 2
    Email author
  • Melissa Gerstle
    • 1
    • 3
  • Lori A. Casnellie
    • 2
  • Colleen Pater
    • 1
    • 4
  • Gylynthia Trotman
    • 5
  1. 1.Department of Pediatrics,University of Cincinnati College of MedicineCincinnatiUSA
  2. 2.Division of EndocrinologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Division of Behavioral Medicine and Clinical PsychologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  4. 4.The Heart InstituteCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  5. 5.Pediatric and Young Women’s GynecologyBoston Children’s Health Physicians, Westchester Medical Center, New York Medical CollegeValhallaUSA

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