Klinefelter syndrome (KS) occurs in some men who have more than one X chromosome (XXY).
Males usually inherit a single X chromosome from their mother and a single Y chromosome from their father. Males with KS get at least one extra X chromosome.
A risk factor is something that increases your chance of KS. Women over age 35 have a slightly increased chance of having a child with KS. There are no other known risk factors for this disorder.
XXY occurs in approximately 1 out of 580 live male births, but many men with it do not develop KS. When KS does develop, it usually goes undetected until puberty or sometimes much later.
Characteristics may include:
For babies:
Smaller birth weight and slower muscle and motor development
For children and adults:
Tallness with extra long arms and legsAbnormal body proportions (long legs, short trunk)Enlarged breasts (common)Lack of facial and body hairSmall firm testes, small penisLack of ability to produce sperm (common)Diminished sex drive, sexual dysfunctionSocial and learning disabilities (common)Personality impairmentAttention deficit hyperactivity disorder
(ADHD)Normal to borderline IQSpeech and language problems—Children with KS often learn to speak later than other children do. They may have a difficult time reading and writing.
Men with KS have an increased risk of:
Type 2 diabetesBreast cancerLung cancerCardiovascular diseaseLung diseaseOsteoporosisHypothyroidismDental problemsLeg ulcersA test called a karyotype is used to diagnose KS. In the case of KS, there are usually 47 chromosomes rather than the normal 46.
Many men with XXY do not know they have the condition. The diagnosis may be found:
When
amniocentesis
is done
In babies—undescended testes
or very small penis
In children—when the child is having problems learningIn adolescents—when the child has excessive breast development
In adults—when the man has
fertility
concerns
Treatment of KS includes:
The main treatment is
testosterone. When boys with KS are 10-12 years old, their hormone levels are checked yearly. If testosterone levels are low, then treatment may be helpful. Men diagnosed may also benefit from taking the hormone. However, testosterone cannot reverse infertility.
Testosterone is most often given through regular shots or a skin patch. The benefits include:
Increased strengthMore muscular, male appearanceGrowth of facial and body hairBetter self-esteemModulation of moodIncreased energyIncreased ability to concentrateGreater sex driveImproved bone density
This therapy should begin in early childhood to avoid social and school learning problems. Treatment may involve:
Speech therapySpecial education servicesExtra support and help with learning from parents and teachersSocial skills training and psychological counselingCurrently, there are no known ways of preventing KS.
Last reviewed September 2012 by Kari Kassir, MD
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