••• Chapter 53^ Amenorrhea^537
❍ If a patient has Turner’s syndrome clinically, what other things must you evaluate or consider?
Autoimmune disorders are common and include thyroiditis, type 1 diabetes, autoimmune hepatitis,
thrombocytopenia and celiac disease.
Cardiovascular abnormalities- present in ~ 1 /3 and include bicuspid aortic valve, coarctation of the aorta, MVP, and
aortic aneurysm.
renal abnormalities include horseshoe kidney, unilateral renal agenesis or pelvic kidney, rotational abnormalities,
and partial or complete duplication of the colleting system.
Karyotype—since 40% are mosaic and may have XY aberrations.
❍ When should evaluation of a patient begin if a patient is amenorrheic after discontinuing oral contraceptive
pills (OCPs) and after discontinuing Depo-Provera?
- 6 months after oCP’s discontinued.
- 12 months after the last injection of Depo-Provera.