The purpose of this study is to examine whether a larger dosage of estrogen than the one used today will secure the development of a normal sized uterus and increase the strength of the bones in girls and young women with Turner syndrome. The purpose is also to evaluate whether aortic dilatation is present in this group of patients, and if the estrogen dosage will influence the emotional well-being and self-esteem of the patients.
Turner syndrome is a common chromosomal disorder with only one X-chromosome or partial deletions in one X-chromosome in all or some of the cell-lines in the body. Appr. 18 girls/year are being born with the syndrome in Denmark. The syndrome is mostly known for reduced final height and the lack of pubertal development with infertility, but it is also known for diseases influencing other parts of the body like the heart with the risk of development of aortic dilatation and subsequently dissection with the risk of rupture, profuse bleeding and sudden death. Reduced bone strength and increased risk of bone fracture are also features of the syndrome. Treatment with growth hormone and female sex-hormones are well-established treatments. Girls and young women with Turner syndrome ages 10 to 21 years will participate. The girls ages 15 to 21 years will randomly and double blindly receive treatment with either 2 mg or 4 mg estrogen for 5 years. Yearly examinations with blood tests, physical examinations, questionnaires, ultrasound and MR-scan of the internal female genitalia, DEXA-scan of the bones and MR-scan of the heart will be performed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
43
tablets, 2 mg day 1 through day 22 of the menstrual cycle for 5 years
Pediatric Unit, Hillerod Hospital
Hillerød, Frederiksborg County, Denmark
The size of the uterus evaluated by magnetic resonance (MR)-scan
Time frame: 5 years
Bones evaluated by dual-energy X-ray absorptiometry (DEXA)-scan
Time frame: 5 years
The diameter of the aortic root evaluated by MR-scan
Time frame: 5 years
Development of biochemical markers
Time frame: 5 years
Body composition evaluated by DEXA-scan
Time frame: 5 years
Emotional wellbeing and self-esteem evaluated by questionnaires
Time frame: 5 years
The size of the uterus evaluated by ultrasound
Time frame: 5 years
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