Transitioning the patient with Turner's syndrome from pediatric to adult care

The level of medical and neuropsychological complexity throughout the life span of a patient with Turner's syndrome (TS) provides the rationale for a more structured transition from pediatric to adult health care. During late adolescence, the focus of care shifts from maximizing final adult height to completing feminization with estrogen therapy, detecting early antecedents of associated adult conditions, implementing needed therapeutic lifestyle changes, and assessing psychobehavioral risk. An increased prevalence of the dysmetabolic syndrome and osteoporosis is observed in TS. The prevention of obesity and assurance of adequate calcium intake and weight-bearing activities combined with early detection and treatment of specific abnormalities can ameliorate these associated adult morbidities. During the final phase of transition, the pediatric endocrinologist should engage the patient with TS in developing a comprehensive adult care roadmap or 'transition passport', which serves as a powerful educational tool. The aim of refining the transition process is to improve adult outcomes and quality of life for patients with TS.