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Debido a la aparición de transtornos durante la edad adulta, tales como malformaciones cardíacas adquiridas o alteraciones metabólicas, autoinmunes o neurosensoriales, estas pacientes deberían derivarse a unidades de endocrinología ginecológica especializadas. Está justificado un seguimiento especializado multidisciplinario durante la edad adulta, que asegure un cribado y manejo correcto de las alteraciones asociadas a los hipogonadismos, así como una terapia hormonal adaptada a las necesidades de cada paciente, así como consejo sexual y reproductivo (Tabla 2).

Tabla 2. Propuesta de seguimiento e las pacientes con Síndrome de Turner en la edad adulta.
REFERENCIAS
1. Donalson MDC, Gault EJ, Tan KW, Dunger DB. Optimising management in Turner síndrome: from infancy to adult trasfer. Arch Dis Child (2006) 91:513-520. 2. Conway GS. The impact and manegement of Turner’s síndrome in adult life. Best Practice and Research Clinical Endocrinology and Metabolism (2002). 16: 243-261. 3. Elsheikh M, Dunger DB, Conway GS, Wass JAH. Turner’s síndrome in adulthood. Endocrine Reviews (2003) 23:120-140. 4. Bianco SDC, Kaiser UB. The genetic and molecular basis of idiophatic hypogonadotropic hypogonadism. Nat Rev Endocrinol (2009) 5:569-576. 5. Cariboni A, Maggi R. Kallmann’s syndrome, a neuronal migration defect. Cell Mol Life Sci (2006) 63:2512-2526. 6. Gravholt C. Epidemiological, endocrine and metabolic features in Turner síndrome. European JNournal of Endocrinology (2004) 151: 657-687. 7. Bannink EM, van Sassen C, van Buurent S, de Jong FH, Lequin M, Mulder PGH. Puberty induction in Turner syndrome: results of oestrogen treatment on development of secondary sexual characteristics, uterine dimensions and serum hormone leves. Clin Endocrinol (2009) 70:265-273. 8. Castelo-Branco C, León M, Durán M, Balasch J. Follicle-stimulating hormones does not directly regulate bone mass in human beings: evidence from nature. Fertil Steril (2008) 90: 2211-2216.
9. Doerr HG, Bettendorf M, Hauffa BP, Mehls O, Partsch CJ. Uterine size in women with Turner syndrome alter induction of puberty with estrogens and long-term growth hormona therapy: results of the German IGLU Follow-up Study 2001. Human reproduction (2005) 5:1418-1421 10. Foudila T, Soderstrom-Anttila V, Hovatta O. Turner’s syndrome and pregnancies after oocyte donation. Human reproduction (1999) 14:532-535 11. Breuil V, Euler-Ziegler L. Gonadal dysgenesis and bone metabolism. Joint Bone Spine (2001) 68:26-33 12. Bakalov V, Bondy CA. Fracture risk and bone mineral density in Turner syndrome. Rev Endocr Metab Disord (2008) 9:145-151. 13. Bondy CA, Heart disease in Turner syndrome. Minerva Endocrinol. 2007;32:245-61 14. Thomas J, Yetman AT. Management of cardiovascular disease in Turner syndrome. Expert Rev Cardiovasc Ther. (2009) 7:1631-41. 15. Ross MT, et al. The DNA sequence of the human X chromosome. Nature. (2005) 434:325-37. 16. Cooley M, Bakalov V, Bondy CA. Lipid profiles in women with 45X vs 46XX Primary ovarian failure. JAMA (2003) 290:2127-2128. 17. Mortersen KH, Cleemann L, Hjerrild BE, Nexo E, Locht H, Jeppesen EM, Gravholt CH. Increased prevalence of autoimmunity in Turner syndrome: influence of age. Clinical and Experimental Immunology (2009) 156:205-210. 18. Persani L, Rossetti R, Cacciatore C, Bonomi M. Primary ovarian insufficiency: X chromosome defects and autoimmunity. Journal of Autoimmunity (2009) 33:35-41. 19. Larizza D, Calcaterra V, Martinetti M. Autoimmune stigmata in Turner syndrome: when lacks an X chromosome. Journal of Autoimmunity (2009) 33:25-30. 20. Su MA, Stenerson M, Liu W, Putnam FC, Bluestone JA, Anderson MS. The role of X-linked FOXP3 in the autoimmune susceptibility of Turner Syndrome patients. Clinical Immunology (2009) 131:139-144. 21. Stenberg AE, Sylvén L, Magnusson CGM, Hultcrantz M. Immunological parameters in girls with Turner syndrome. Journal of Negative Results in Biomedicina (2004) 3:1-5. 22. Hernández-Molina G, Svyryd Y, Sánchez-Guerrero J, Mutchinik OM. The role of the X chromosome in immunity and autoimmunity. Autoimmunity Reviews (2007) 6:218-222. 23. Ban Y, Tazki T, Tobe T, Ban Y, Jacobson EM, Concepcion E. The regulatory T cell gene FOXP3 and genetic susceptibility to thyriod autoimmunity: an association analysis in Caucasian and Japanese cohorts. Journal of Autoimmunity (2007) 28:201-207. 24. Liu W, Putnam AL, Xu-Yu Z. CD127 expression inversely correlates with FOXP3 and supressive function of human CD4+ Treg cells. J Exp Med (2006) 203:1701-1711 25. Parkin M, Walker P. Hearing loss in Turner syndrome. Int J Pediatr Otorhinol (2009) 73:243-247. 26. Gawron W, Wikiera B, Rostkowska-Nadolska B, Orendorz-Fraczkowska K, Noczynska A. Evaluation of hearing organ in patients with Turner syndrome. Int J Pediatr Otorhinol (2008) 72:575-579. 27 Hederstierna C, Hultcrantz M, Rosenhall U. Estrogen and hearing from a clinical point of view; characteristics of auditory function in women with Turner syndrome. Hear Res (2009) 252:3-8.
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Revista Centroamericana de Obstetricia y Ginecología Vol. 15, número 4, octubre-diciembre 2010
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