There are no established measures for the secondary prevention of Turner Syndrome. Secondary prevention is aimed at preventing complications of Turner syndrome. This involves frequent screening of complications.

• There are no established measures for the secondary prevention of Turner Syndrome. Secondary prevention is aimed at preventing complications of Turner syndrome.
• Echocardiography for cardiac structural abnormalities especially aortic dilation that predisposes the individual to aortic dissection and sudden cardiac death.
  • The aortic severity index is a useful prognostic indicator when assessing for the risk of aortic dilatation. ^[1]
  • It is the aortic diameter corrected for body surface area and a score of more than 2.3 cm per metre square indicates a high risk of aortic dissection (2-2.3 cm per metre square is considered as moderate risk).
  • The advice offered to moderate risk patients is restriction of activities and that offered to high risk patients is that they should completely avoid competitive sports and intensive weight training.
• Renal ultrasound for structural abnormalities like duplication of the collecting system and horseshoe shaped kidney.
• Dual energy x-ray absorptiometry (DEXA) scans may be done to test bone mineral density.
• Audiology for sensorineural and conductive hearing loss.
• Multidisciplinary neuropsychiatric evaluation should be done at major transitional stages such as preschool entry and high school entry. ^[2]
• ECGs should be performed as long QT syndrome frequently occurs secondary to medication used to treat complications of Turner syndrome.
• Individuals with a Y karyotypic abnormality should be screened with fluorescent insitu hybridization and polymerase chain reaction techniques, to detect the risk of developing a gonadoblastoma.
• Laboratory investigations that may help in screening include: ^[3]
  1. Serum gonadotrophins and anti Mullerian hormone– ovarian reserve.
  2. Renal function tests – renal failure secondary to structural abnormalities.
  3. Thyroid function tests – thyroiditis, [hypothyroidism]], hyperthyroidism
  4. Liver function tests – focal nodular hyperplasia
  5. Serum IgA, IgA anti endomysium antibodies and IgA antigliadin antibodies – Celiac disease
  6. Lipid profile – hyperlipidemia
  7. Oral glucose tolerance test and serum glycosylated hemoglobin – for type 2 diabetes mellitus.
  8. Serum 25-hydroxyvitamin D– Vitamin D deficiency.

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