Turner Syndrome

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Classification according to ICD-10
Q96.- Turner Syndrome
Q96.0 Karyotype 45, X
Q96.1 Karyotype 46, X iso (Xq)
Q96.2 Karyotype 46, X with gonosomal abnormality, except iso (Xq)
Q96.3 Mosaic, 45, X / 46, XX or 45, X / 46, XY
Q96.4 Mosaic, 45, X / other cell line (s) with gonosomal abnormality
Q96.8 Other variants of Turner syndrome
Q96.9 Turner syndrome, unspecified
ICD-10 online (WHO version 2019)
Karyogram 45, X
Wing skin: The shape of the neck can appear in Ullrich-Turner syndrome. The girl is shown before and after the operation.

The Turner Syndrome , also under the synonyms Turner syndrome ( UTS ) or monosomy X (formerly state Bonnevie-Ullrich ), is occurring in women congenital disease (gonadal dysgenesis with hypogonadism) with a variety of symptom possibilities, the cause of a gonosomal Monosomy is. With this chromosome aberration , instead of two sex chromosomes (XX or XY) there is only one functioning X chromosome in the body cells.

As early as 1929, the German pediatrician Otto Ullrich reported abnormalities in Ullrich-Turner syndrome. The abnormality was first described from a scientific point of view by the American endocrinologist Henry H. Turner (1892–1970) in 1938. 50% of affected women have the karyotype 45, X (or 45, X0), while around 40% of those affected have a mosaic in which there are both cells with one and cells with two or more X chromosomes.

root cause

The cause of the syndrome is an incorrect distribution of the chromosomes, usually during postmeiotic germ cell division , i.e. the development of the parents' sperm or egg cell; the error usually occurs on the paternal side and a sperm with only 22 chromosomes is formed (instead of 23, X or 23, Y). Theoretically, this can happen with all chromosomes - but it can only lead to a viable organism in the gonosomes. However, 95-99% of the 45, X pregnancies also end in an abortion and are thus the most common cause of spontaneous abortions. Either one gonosome is missing completely in all cells (45, X or 45, X0), or there is a structurally abnormal X chromosome (the second X chromosome is circular or smaller), or a mosaic with a so-called marker is created Chromosome (45, X / 46, X, mar) or other combinations (45, X / 46, XX), (45, X / 46, XY), (45, X / 47, XXX).

frequency

Out of 2500 births of girls, one is born with Ullrich-Turner syndrome. This makes Turner syndrome the most common form of gonadal dysgenesis in women. It is estimated that around 3% of female embryos have a functional monosomy X, of which around 98-99% die in the course of pregnancy , which then usually ends with a miscarriage within the first three months of pregnancy.

Common features

The intelligence of girls or women with Turner syndrome is average. The life expectancy is not reduced. Often the UTS is only discovered at elementary school age, as the girls were previously inconspicuous.

Girls / women with Turner syndrome can lead a normal life and develop largely regularly through hormone treatment from the age of 12 onwards. The infertility remains by not to because of the lack of follicles usually ovulate enabled ovaries exist. If you wish to have children, egg donation treatment could be carried out, but this is currently prohibited in Germany.

Except for treating the symptoms , no therapy is possible.

Although 98% of the affected embryos still die in the womb, Turner syndrome is the only case that allows development when there are too few chromosomes. This is due to the double gene activity of the X chromosome , which compensates for the lack of gene activity on the Y chromosome in men . Treatment of the malformations is also possible, for example by giving growth hormones to prevent short stature. The affected child is injected with growth hormone every day from around the age of 4 to reduce short stature. However, there is no absolute guarantee of success for this therapy.

Normally, from the age of twelve, treatment with the female sex hormones (estrogens) is carried out, which are supposed to induce breast formation. Progesterones, which lead to the onset of menstruation, are added later.

literature

  • Angelika Bock: Living with the Ullrich Turner Syndrome. Reinhardt, Munich 2002, ISBN 3-497-01618-7 .
  • Thomas Mohnike : A life with Ullrich Turner syndrome . (PDF) patient brochure. Illustrations: Heide Henschel. Turner Syndrome Association Germany V., Frankfurt / M. 2015.
  • Klaus Sarimski: Developmental Psychology of Genetic Syndromes. 3. Edition. Hogrefe, Göttingen 2003, ISBN 3-8017-1764-X .
  • Manfred Stauber, Thomas Weyerstahl: Gynecology and Obstetrics (= dual series. ) Thieme, Stuttgart 2001, ISBN 3-13-125341-X , pp. 34–35.
  • Natura biology for vocational high schools. Professional advanced level. Stuttgart 2011, ISBN 978-3-12-045306-2 , p. 125.
  • Anne-Christine Ermisch: X TIMES DIFFERENT - Ullrich Turner Syndrome - yes and ?! 2014 ISBN 978-3-86468-816-4 , p. 144
  • Lois Jovanovic, Genell J. Subak-Sharpe: Hormones. The medical manual for women. (Original edition: Hormones. The Woman's Answerbook. Atheneum, New York 1987) From the American by Margaret Auer, Kabel, Hamburg 1989, ISBN 3-8225-0100-X , pp. 53, 262 f. and 386.

Web links

Commons : Turner Syndrome  - Collection of Pictures, Videos, and Audio Files

See also

Individual evidence

  1. ^ Heinz-Peter Schmiedebach : Turner, Henry Hubert. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1425.
  2. ^ HH Turner: A Syndrome of Infantilism, Congenital Webbed Neck, and Cubitus Valgus . In: Endocrinology . Volume 23, 1938, pp. 566-574.
  3. ^ Gustav-Adolf von Harnack, Berthold Koletzko: Pediatric and Adolescent Medicine . Springer-Medizin-Verlag, Heidelberg 2007, ISBN 978-3-540-48632-9 .
  4. ^ Marion Kiechle: Gynecology and Obstetrics . Elsevier, Urban & Fischer, Munich 2011, ISBN 978-3-437-42407-6 .
  5. ^ Heinrich Schmidt-Matthiesen, Dietrich von Fournier: Gynecology and obstetrics textbook for study and practice . Schattauer, Stuttgart 2004, ISBN 3-7945-2260-5 .
  6. M. Macsai, E. Maguen, P. Nucci: Keratoconus and Turner's syndrome. In: Cornea . Volume 16, Number 5, September 1997, pp. 534-536, PMID 9294684 ; air.unimi.it (PDF)