¨A síndrome de Klinefelter (SK) é a causa mais comum de hipogonadismo masculino e a anomalia de cromossomos sexuais mais comum em homens, com uma prevalência estimada de um em cada 600 homens nascidos vivos. Caracteriza-se citogeneticamente pela presença de um cromossomo X extra (47,XXY), que ocorre em cerca de 90% dos casos; porém, variantes da SK, como o mosaicismo (46,XY/47,XXY) e outras aneuploidias mais raras (48,XXXY, 48,XXYY, 49,XXXXY) já foram descritas. Os achados clínicos principais, presentes em quase todos os indivíduos com SK, são os testículos pequenos, a azoospermia e o aumento das gonadotrofinas, em especial do follicle stimulating hormone (FSH); porém, outros achados, como ginecomastia, atraso puberal, pilificação pubiana e corporal diminuídas, micropênis, alta estatura, aumento da envergadura em relação à estatura, distúrbios de aprendizado, doenças psiquiátricas, doença venosa periférica, obesidade abdominal, síndrome metabólica, maior risco de doenças autoimunes e câncer, podem ser observados com diferentes frequências de acordo com a população avaliada, a faixa etária incluída e o cariótipo encontrado. É uma doença de curso crônico com sérias repercussões sobre o aparelho reprodutor masculino, sendo importante causa de infertilidade em nível mundial. A SK continua sendo uma doença pouco diagnosticada, pois os pacientes procuram pouco os médicos, e os médicos nem sempre estão atentos ao diagnóstico. Por isso, apenas cerca de 25% de todos os pacientes adultos com SK são diagnosticados; a maioria durante a investigação de infertilidade e/ou hipogonadismo; e menos de 10% de todos os casos com SK são diagnosticados antes da puberdade. ¨

 

Klinefelter syndrome in childhood: variability in clinical and molecular findings

N Akcan, S Poyrazoglu, F Bas et AL

J Clin Res Pediatr Endocrinol 2018; 10: 100-107

http://www.jcrpe.org/archives/archive-detail/article-preview/klinefelter-syndrome-in-childhood-variability-in-c/17042

 

Application of neural networks for classification of Patau, Edwards, Down, Turner and Klinefelter syndrome based on first trimester maternal serum screening data, ultrasonographic findings and patient demographics

Catic A, Gurbeta L, Kurtovic-Kozaric A, Mehmedbasic S, Badnjevic A.

BMC Med Genomics. 2018 Feb 13;11(1):19

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812210/

 

DNA hypermethylation and differential gene expression associated with Klinefelter syndrome

Anne Skakkebæk, Morten Muhlig Nielsen, Christian Trolle et al

Sci Rep. 2018; 8: 13740

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137224/

 

Next generation sequencing expression profiling of mitochondrial subunits in men with Klinefelter syndrome

Michele Salemi, Laura Cimino, Marika Marino et AL

Int J Med Sci. 2018; 15(1): 31–35

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5765737/

 

Aberrant ocular architecture and function in patients with Klinefelter syndrome

Cristin Brand, Michael Zitzmann, Nicole Eter et al

Sci Rep. 2017; 7: 13130

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640645/

 

The role of genes, intelligence, personality, and social engagement in cognitive performance in Klinefelter syndrome

Anne Skakkebæk, Philip J. Moore, Anders Degn Pedersen et al

Brain Behav. 2017 Mar; 7(3): e00645

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346527/

 

Klinefelter syndrome (KS): genetics, clinical phenotype and hypogonadism

  1. Bonomi, V. Rochira, D. Pasquali, G. Balercia et al

On behalf of the Klinefelter ItaliaN Group (KING)

J Endocrinol Invest. 2017; 40(2): 123–134

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5269463/

 

Klinefelter syndrome comorbidities linked to increased X chromosome gene dosage and altered protein interactome activity

Kirstine Belling, Francesco Russo, Anders B. Jensen et al

Hum Mol Genet. 2017 Apr 1; 26(7): 1219–1229

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5390676/

 

Effects of oxandrolone on cardiometabolic health in boys with Klinefelter syndrome: a randomized controlled trial

S M Davis, M G Cox-Martin, M Z Bardsley et al

The Journal of Clinical Endocrinology & Metabolism 2017, vol 102 (1): 176-184

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413098/

 

A rare 47 XXY/46 XX mosaicism with clinical features of Klinefelter syndrome

N S M Nor, M Y Jalaludin

Int J Pediatr Endocrinol 2016, 2016: 11

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890323/

 

High risk of venous thromboembolism in Klinefelter syndrome

Bengt Zöller, Jianguang Ji, Jan Sundquist, Kristina Sundquist

J Am Heart Assoc. 2016 May; 5(5): e003567

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889210/

 

Klinefelter syndrome hás increased brain response to auditory stimuli and motor output, but not to visual stimuli or Stroop adaptation

Mikkel Wallentin, Anne Skakkebæk, Anders Bojesen et al

Neuroimage Clin. 2016; 11: 239–251

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773384/

 

Distinctive pattern of expression of spermatogenic molecular markers in testes of azoospermic with non-mosaic Klinefelter syndrome

Sandra E. Kleiman, Leah Yogev, Ofer Lehavi et al

J Assist Reprod Genet. 2016 Jun; 33(6): 807–814

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4889481/

 

Bone mineral status in children and adolescents with Klinefelter syndrome

Stefano Stagi, Mariarosaria Di Tommaso, Cristina Manoni et al

Int J Endocrinol. 2016; 2016: 3032759

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927985/

 

Advances in the interdisciplinary care of children with Klinefelter syndrome

Shanlee Davis, Susan Howell, Rebecca Wilson, Tanea Tanda, Judy Ross, Philip Zeitler, Nicole Tartaglia

Adv Pediatr. 2016 Aug; 63(1): 15–46

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5340500/

 

Testis development and reproductive options in males with Klinefelter syndrome

Shanlee M. Davis, Alan D. Rogol, Judith L. Ross

Endocrinol Metab Clin North Am. 2015 Dec; 44(4): 843–865

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648691/

 

Testicular parenchymal abnormalities in Klinefelter syndrome: a question of cancer? Examination of 40 consecutive patients

Giacomo Accardo, Gianfranco Vallone, Daniela Esposito et al

Asian J Androl. 2015 Jan-Feb; 17(1): 154–158

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291860/

 

Factors associated with adaptation to Klinefelter syndrome: the experience of adolescents and adults

Amy Turriff, Howard P. Levy, Barbara Biesecker

Patient Educ Couns. 2015 Jan; 98(1): 90–95

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5160995/

 

Mild deficits of cortical bone in adults with Klinefelter syndrome or anorchia treated with testosterone

S Choong Wong, D Scott, A Lim et al

The Journal of Clinical Endocrinology & Metabolism 2015, vol 100 (9)

https://academic.oup.com/jcem/article/100/9/3581/2830530

 

Antropometry in Klinfelter syndrome – multifactorial influences due to CAG length, testosterone treatment and possibly intrauterine hypogonadism

S Chang, A Dkakkebaek, C Trolle et al

The Journal of Clinical Endocrinology & Metabolism 2015, vol 100 (3)

https://academic.oup.com/jcem/article/100/3/E508/2840006

 

Comorbidity between Klinefelter syndrome and diaphragmatic hernia

C M Valdez et al

Sao Paulo Med. J., 2014, vol.132, no.5, p.311-313

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000500311&lng=pt&nrm=isso

 

Homicide and Klinefelter syndrome: a complex interaction.

Richard-Devantoy, Stéphane et al.

Rev. Bras. Psiquiatr., May 2014, vol.36, no.2, p.153-156

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462014000200153&lng=en&nrm=iso

 

Comorbidity between Klinefelter syndrome and diaphragmatic hernia. A case report.

Valdez, Carolina Melendez et al.

Sao Paulo Med. J., 2014, vol.132, no.5, p.311-313

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802014000500311&lng=en&nrm=iso

 

The role of hypogonadism in Klinefelter syndrome

Christian Høst, Anne Skakkebæk, Kristian A Groth, Anders Bojesen

Asian J Androl. 2014 Mar-Apr; 16(2): 185–191

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955327/

 

Homicide and Klinefelter syndrome: a complex interaction.

Richard-Devantoy, Stéphane et al.

Rev. Bras. Psiquiatr., May 2014, vol.36, no.2, p.153-156

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462014000200153&lng=en&nrm=iso

 

Klinefelter syndrome: the commonest form of hypogonadism, but often overlooked or untreated

Eberhard Nieschlag

Dtsch Arztebl Int. 2013 May; 110(20): 347–353

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674537/

 

Gene expression patterns in relation to the clinical phenotype in Klinefelter syndrome

M Ziltzmann, R Bongers, S Werler et al

The Journal of Clinical Endocrinology & Metabolism 2013, vol 100 (3)

https://academic.oup.com/jcem/article/100/3/E518/2840008

 

Síndrome de Klinefelter: diagnóstico raro na faixa etária pediátrica

Tincani, Bruna J. et al.

  1. Pediatr. (Rio J.), Ago 2012, vol.88, no.4, p.323-327

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572012000400008&lng=en&nrm=iso

 

Insulin resistance and metabolic syndrome in prepubertal boys with Klinefelter syndrome

Martha Z Bardsley, Bonita Falkner, Karen Kowal, Judith L Ross

Acta Paediatr. 2011 Jun; 100(6): 866–870

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164507/

 

Klinefelter syndrome – a clinical update

K A Groth, A Skakkebaed, C Host et al

The Journal of Clinical Endocrinology & Metabolism 2013, vol 98 (1): 20-30

https://academic.oup.com/jcem/article/98/1/20/2823039

 

Leg ulcers associated with Klinefelter´s syndrome: a case report and review of the literature

V K Shanmugam, K C Tsagaris, C E Attinger

Int Wound J 2012, vol 9 (1): 104-107

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664240/

 

Klinefelter syndrome presenting as behavioral problems in a young adult

Alexandra M. Molnar, Genji S. Terasaki, John K. Amory

Nat Rev Endocrinol. 2010 Dec; 6(12): 707–712

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4271651/

 

Síndrome de Klinefelter en las distintas edades: experiencia multicêntrica

Pacenza, N. et al.

Rev. argent. endocrinol. metab., Dic 2010, vol.47, no.4, p.29-3

http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1851-30342010000400005&lng=es&nrm=iso

 

The cognitive phenotype in Klinefelter syndrome: a review of the literature incluing genetic and hormonal factors

Richard Boada, Jennifer Janusz, Christa Hutaff-Lee, Nicole Tartaglia

Dev Disabil Res Rev. 2009; 15(4): 284–294

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056507/

 

Atypical presentation of Prader-Willi syndrome with Klinefelter (XXY karytype) and craniosynostosis

Carvalho, Daniel R., Trad, Clovis S. and Pina-Neto, João M.

Arq. Neuro-Psiquiatr., June 2006, vol.64, no.2a, p.303-30

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2006000200024&lng=en&nrm=iso&tlng=en

 

Klinefelter syndrome

D J Watterndor, M Muenke

Am Fam Physician 2005, vol 72 (11): 2259-2262

https://www.aafp.org/afp/2005/1201/p2259.html

 

Mortality in patients with Klinefelter syndrome in Britain: a cohort study

A J Swerdlow, C D Higgins, M J Schoemarker et al

The Journal of Endocrinology & Metabolism 2005, vol 90 (12): 6516-6522

https://academic.oup.com/jcem/article/90/12/6516/2837167

 

Síndrome de Klinefelter associada a lupus eritematoso sistêmico: Interferência dos esteróides sexuais.

Rangel, Arquimedes de A. et al.

Arq Bras Endocrinol Metab, Jun 2002, vol.46, no.3, p.299-30

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302002000300014&lng=pt&nrm=iso

 

Diagnóstico tardio da síndrome de Klinefelter : relato de caso.

Maia, Frederico F.R. et al.

Arq Bras Endocrinol Metab, Jun 2002, vol.46, no.3, p.306-309

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302002000300015&lng=pt&nrm=iso

 

by Dr Paulo Fernando Leite

Cardiologia/Prevenção Cardiovascular

Estratificação de Risco Cardiovascular

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