Growth-hormone and estrogen replacement in Turner's syndrome - a retrospective analysis

Abstract

Introduction: Turner's syndrome (TS) constitutes an important cause of short stature and gonadal dysgenesis. As such, growth-hormone treatment (GHT) and estrogen-replacement therapy (ERT) aim to improve height outcome and mimic normal pubertal progression. Objectives: Analyse clinical data of TS patients with special focus on the mentioned treatments. Methods: A retrospective analysis of TS patients who underwent GHT and/or ERT between 01.01.2002 and 30.09.2022 at a level III university hospital was conducted. Results: Study population included 35 patients with a mean current age of 21.9 years. The most frequent chromosomal anomaly was 45X0. Mean age at initiation of GHT was 7.8 years with a mean dosage of 0.038±0.008 mg/kg/day. 13 patients have finished GHT, achieving a mean final height of 140cm (-2.5 SDS). Even though no girl was able to reach mid-parental height, they were significantly closer to it at end of treatment. ERT was administered via transdermal estrogen patch in all cases. Mean age at initiation of ERT was 13.2 years. Comparing the two decades of study, there were more prenatal diagnoses during the second decade, but no relation was found between date of diagnosis and final height or age at initiation of either GHT and ERT. Discussion: We highlight the importance of a prenatal diagnosis and of ensuring treatments are offered at appropriate ages. Although no statistically significant differences were found regarding final height, probably due to our small study-population, there were more prenatal diagnoses and referrals to fertility appointments during the second decade.