Turner syndrome

ICD-10 Q96.9 · ICD-11 LD50.0

Treatment of Turner Syndrome with Short Stature Diagnosed After Age 12

When Turner syndrome is identified after the age of 12 in a girl who still has short stature and open epiphyses, the growth window remains open — and the treatment approach is tailored specifically to this later-diagnosed scenario.

Clinical Scenario

This protocol applies to girls with a confirmed Turner syndrome diagnosis made after 12 years of age who present with short stature and demonstrable remaining growth potential (open epiphyses). Recognising this specific combination — later diagnosis plus active growth potential — is key to selecting the appropriate management strategy.

Treatment Approach

Current evidence supports a combined hormonal strategy. The approach involves an estrogen-based therapy used alongside a growth-directed hormonal intervention — with the two initiated in a coordinated fashion. The complete regimen, including agent selection, sequencing, and monitoring, is available in the full protocol.

Specific agents, doses, and protocol details are in the full structured regimen below.

References

DOI: 10.1093/ejendo/lvae050

In individuals with a later diagnosis (>12 years) who have short stature and remaining growth potential, we suggest initiating treatment with low dose 17β-estradiol (E2) simultaneously with GH.

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