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Management of cardiovascular complications in Klinefelter syndrome patients

Article title: Management of cardiovascular complications in Klinefelter syndrome patients

Authors: Giacomo Accardo, et al., University of Campania, Italy

Date of Publication: February 2019

“Klinefelter syndrome (KS) shows increased mortality when compared with mortality rates among the general population. Cardiovascular, hemostatic, metabolic diseases are implicated. Moreover, cardiac congenital anomalies in KS can contribute to the increase in mortality.”

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2019-07-19T14:42:12-04:00Categories: 47,XXY (Klinefelter)|

What is XYY? Meet Steve and Find Out

AXYS shares articles about our community members to help you gain understanding of X and Y chromosome variations on a personal level. Please enjoy this article and learn about XYY. Note: The name “Steve” is a pseudonym used upon request.

You’d notice Steve. A stocky guy, 6’6’’ tall, is hard to miss. But like most men with an X or Y variation, medically known as a sex chromosome aneuploidy (SCA), everyone missed his condition. 

As a child, Steve liked to sit quietly in the back of the class and daydream. He was a smart kid from an academically accomplished family. His teachers and family thought he was just not applying himself. “It was tough to hear the comments from ‘why are you acting so immature?’ to ‘what’s wrong with you?’ over and over.” 

He knew he was different and that school was harder for him, but nobody could explain why. In middle school his family finally got him tested. The child development experts diagnosed him with ADD and dyslexia and put him on medication. Steve did not react well to the meds; they gave him night terrors. 

Not only was school difficult, he had physical differences too. “I had low muscle tone,” said Steve. “That made sports challenging. I’d rather do individual activities like hiking.”  His parents required him to play sports. That was not enjoyable for a boy who had a harder time keeping up physically, found it hard to focus, and who missed social cues. Steve was not timid physically—he loved extreme sports like glade skiing. He also loved solitude and quiet. “I’d go hide in a corner and read a magazine.”

In spite of his challenges, Steve made it to college where he was an average student.  His love of learning served him well. “I like to go to museums, travel to places and explore. Reading about places is not enough.”

Despite social challenges, he married a college professor. When they had trouble getting pregnant they discovered he was not fertile because he produced no sperm. A low sperm count is not that unusual but to produce zero sperm was puzzling. 

Steve wanted to know: why he did not produce any sperm? Why did he get migraines? Why was his muscle tone low? Why did his hands get shaky? Why was he so much taller than his 5’ 9” father? But then came the Internet. Steve began to research his medical issues.

He came across something called Klinefelter Syndrome and took his knowledge to his primary care doctor. The doctor agreed to order some tests, but Steve, tired of waiting for answers, checked off a few more boxes on the lab sheet making sure a battery of tests was ordered, increasing the likelihood that he’d finally get the answer he sought. It was good thing he did, as he discovered his hormone levels were off. 

Steve was referred to an endocrinologist who ordered a karyotype (a picture of a person’s chromosomes) that finally gave him the answer. He had an extra sex chromosome. But not as he suspected–an extra X; Steve has an extra Y.  

He found a doctor that had treated men with XXY but never XYY. The condition is half as common–XYY affects about 1 in 1,000 males. In some individuals, the manifestations of XYY are mild and barely noticeable, while others have more severe symptoms. 

Steve read every research article on XYY he could find online. He learned that about 30% of those with XYY are diagnosed with an autism spectrum disorder. That explained his social issues. While most males with XYY have intelligence in the normal range, many have language-based and other learning disabilities. Other possible concerns include social skill disabilities, immaturity, low self-esteem, ADHD, impulsivity, and anxiety or mood disorders. After learning all of this Steve thought, “This sounds like me.” 

The difficulties a person with XYY has can be alleviated with medical and educational interventions. Speech and motor skill difficulties respond to therapy. Anxiety and mood disorders or ADHD can be treated with behavioral therapy, occupational therapy, and sometimes, appropriate medication. Special education accommodations and teaching methods can help those with XYY achieve academic success despite learning disabilities. Some individuals with XYY have significant anxiety related to school, and a change to a smaller classroom environment or an alternative learning setting, including part-time home schooling, can help. If only Steve had been diagnosed sooner. 

Sadly, when Steve got his diagnosis, his wife left him, citing his diagnosis. They had adopted a child who Steve raised as a single parent. Steve has a great job as the Student Center Administrator at a university; he’s been there over 30 years. “I learned that I need a hands-on job,” said Steve.  “I would not do well sitting behind a desk.” Steve described how he, like everyone, had to find his niche. He recommends that everyone “find where you fit in life.” 

It has not always been easy. His job was jeopardized by misunderstandings with a manager, but disclosing his diagnosis to the HR department and filing a claim with the EEOC straightened out the problem. “I knew the sudden poor performance reviews, when I had been a stellar employee, were discrimination, so I took action.” 

Today Steve is raising his son and works to educate healthcare providers and parents about XYY. “It is not that bad,” he says. Steve hopes that someday all doctors and educators will be well versed in sex chromosome aneuploidy (SCA) so people affected get diagnosed very young and can receive the interventions that make life easier. “I also hope they will treat the whole person, not just the symptoms. It is a holistic view that aids diagnosis of an SCA and really helps children.”

Steve served on the board of AXYS, the Association for X and Y Variations. He refers parents with questions to their website genetic.org and their toll free Helpline (888-999-9428) or helpline@genetic.org, where trained volunteers answer questions free of charge. He supports AXYS’ efforts to develop clinics for adults with SCA. “We need to know what to expect as we age,” said Steve. “A study back in the 80s reported that the average life expectancy of a man with XYY is 10 years less than average. For an XXY guy it is 5 years less. Maybe we can change that.”

2019-11-13T21:56:33-05:00Categories: 47,XYY|

Reflecting on the 2019 AXYS Family Conference 

We promised that our 2019 AXYS Family Conference would be the best one yet and we achieved that goal. Nearly 400 participants from as far away as Brazil and The Netherlands gained knowledge and understanding in Atlanta. You could feel the strong sense of community and watch friendships blossom. Here are some comments from those who attended in their own words:  

“The people my daughter and I met were amazing.” 

“A real sense of community was present at this conference.” 

“The camaraderie with other parents was invaluable. Seeing our son mingle with the other guys so comfortably. The bowling, pool, and billiards were a hit!”

“This conference has changed our lives, and in return our son’s…AXYS is a family I am proud to have, my admiration of the doctors is off the charts!!!”

“I had a WONDERFUL experience at the conference. I learned so much, and my cup is full of knowledge that I am excited to share. I’m already looking forward to the next conference. Thank you to all the people in the background who got things together. I know it’s a job. Thank you so much.” 

From an exhibitor: “I wanted to thank you for producing a flawless event where researchers and clinicians could share our findings with the families and other professionals. The event felt very well organized and we felt very well taken care of in terms of food and drink, along with comfortable places to talk with families and among ourselves.  Both formal and impromptu discussions about our research with families who have participated in the past, are about to participate in the near future, or are now considering participating thanks to these opportunities, were truly the highlight of the conference.”

AXYS offered live webcasting for the first time. From as far away as Cyprus, 35 families were able to participate from their homes, watching sessions as they happened and submitting questions for the speakers. These sessions were recorded and are available on our YouTube channel

To share knowledge with those who could not join us and to serve as a review for those in attendance the slide decks and the posters are available on our website. We also have slide decks and recordings from past conferences that remain relevant and offer practical knowledge. Visit https://genetic.org/about/conference-mtrls/.

Everyone at AXYS offers deep gratitude to all who learned from our amazing speakers, enjoyed bowling in Wisteria Lanes, gained new friends, participated in group and family portraits, met researchers, and joined support groups. Over 90% reported the conference met or exceeded their expectations and over 80% said they learned what they were hoping to learn. 

Numerous aspects of this event were taken from the suggestions offered after the 2017 conference including: lunch choices, conference t-shirts, having a place for teens and adults to hang out and play cards or board games, having a session with awareness advocates, special ‘retreat’ sessions for parents of infants and toddlers and another retreat on transitioning to adulthood. Most session topics came from our community including: special education, testosterone replacement, fertility, siblings and mental health.  Our thanks to all who offered more great suggestions that we will use to plan the next conference.

More from attendees in their own words: 

My son is not alone… I am not alone and most of all, it was NOT MY FAULT! I have felt so guilty about my son being diagnosed with xxy and always thought I had done something to cause this!” 

“I had a chance to speak with families/caretakers of other XXYY guys and realized that so many of them are going through the same things that our family is going through. It’s nice to know that you are not alone.” 

“I got so much out of the interaction with other KS men and their family members. I shared a lot with them and learned a lot from them”

“Networking was huge. Also great for my young adult son to meet others and meet some great role models.”

“The most valuable part of the conference for me was meeting and interacting with the other Trisomy X families, especially the teens. I loved them all.” 

“Our first conference… day one…what we have learned and the amazing people we have met…there are just no words to express the love and respect 😊…in just one day, we have gained more information, and had things explained to us by the EXPERTS in AXYS that our doctors couldn’t in 11 years!!…And on top of the brilliant minds….each and every Doctor and the entire AXYS family was more caring than the next!!!!!…the information we received today will take us days to digest …lol ….we have learned things today….that our own doctors are misinformed about!!!…This conference will make a difference not just in my sons life ….but in every one of his doctors lives from this day forward ….THANK YOU”

“Not enough words to describe the feeling of satisfaction, friendships formed, knowledge gained, great speakers, good food, amazing Emory Conference Center, and so much more… Thank you Gary GlissmanCarol Meerschaert, and everyone from AXYS and elsewhere who worked so hard to make this Conference such a success! Grateful, hopeful, optimistic and ready to fight harder through this journey. Stronger together as we move forward to break barriers for X and Y Variations!”

(Photos by Stuart Hasson Studios)

2019-08-03T12:52:41-04:00Categories: All Variations|Tags: |

2019 AXYS Family Conference, Atlanta, Georgia

2019 AXYS Family Conference Videos

Conference sessions recorded during the webcast on June 29th and 30th.

Presenter

Presentation

Relevant Variation

Allan Reiss, MDA Roadmap for Advancing Knowledge and Clinical Practice of Brain & Behavioral Effects of X and Y Chromosome VariationAll
Allan Reiss, MD and Vanessa Alschuler, BABrains, Genes, And Puberty: Testosterone Replacement Therapy in Klinefelter Syndrome47,XXY (KS)
Armin Raznahan, MD, PhDThe NIMH Study on X & Y Chromosome Variations - Goals, Study Design, Key Findings & Future PlansAll
B. Michelle Schweiger, DO, MPHMetabolic Syndrome in 47,XXY47,XXY (KS)
Carol Meerschaert, AXYS EDWelcome to the 2019 AXYS Family ConferenceAll
David Marcus, PhDThe Neuropsychological Evaluation and What It Can Tell ParentsAll
Erin Torres, MSN, CRNP and Srishti Rau, PhDPsychiatric and Neurodevelopmental Comorbidities in XXY47,XXY (KS)
Nicole Tartaglia, MDeXtraordinarY Kids Research in ColoradoAll
Rebecca Wilson, PsyDHow Research Can Benefit Families and PatientsAll
Rebecca Wilson, PsyDSocial Skill Challenges, Toddlers to TeensAll
Shanlee Davis, MDClinical Trials in X and Y Variations: Doing Research that MattersAll
Sharron Close, PhD, MS, CPNP-PC, FAANRoadmap to ResearchAll
Sophie van Rijn, PhDResearch Aims: TRIXY National Center of Expertise47,XXY (KS) | 47,XYY | 47,XXX

2019 AXYS Family Conference Session Presentation Slides

Presentation Slides are in PDF Format

Presenter

Presentation

Relevant Variation

Allan Reiss, MDA Roadmap for Advancing Knowledge and Clinical Practice of Brain & Behavioral Effects of X and Y Chromosome VariationAll
Allan Reiss, MD and Vanessa Alschuler, BABrains, Genes, And Puberty: Testosterone Replacement Therapy in Klinefelter Syndrome47,XXY (KS)
B. Michelle Schweiger, DO, MPHMetabolic Syndrome in 47,XXY47,XXY (KS)
David Hong, MDUse of Psychiatric Medications for Serious Mental Health ChallengesAll
David Marcus, PhDThe Neuropsychological Evaluation and What It Can Tell ParentsAll
Dorothy Boothe, PhDTransition to Work and Higher EducationAll
Erin Frith, MEd and Talia Thompson, PhDNavigating the IEP Process and BeyondAll
Erin Torres, MSN, CRNP-PMH and Srishti Rau, PHDPsychiatric and Neurodevelopmental Comorbidities in XXY47,XXY (KS)
Hannah Acevedo, LEP, ABSNP, BCBAPositive Behavior Supports for Home and SchoolAll
Leen Wehbeh, MDMedical Management of Klinefelter Syndrome XXY in Adults47,XXY (KS)
Maria Vogiatzi, MDIndependent Living Skills for Individuals with X and Y Chromosome VariationsAll
Nicole Tartaglia, MDeXtraordinarY Kids Research in ColoradoAll
Paul Dressler, MD, MPHTransitioning from Pediatric to Adult HealthcareAll
Rebecca Wilson, PsyDHow Research Can Benefit Families and PatientsAll
Shanlee Davis, MD, MSHormones in XXY, XXYY, and XXXY47,XXY (KS) | 48,XXYY | 48,XXXY
Sharron Close, PhD, MS, CPNP-PC, FAANRoadmap to ResearchAll
Sophie van Rijn, PhDCognitive and behavioral development of young children with 47,XXY, 47,XXX, and 47,XYY aged 1 to 6 years: first results of the TRIXY study47,XXY (KS) | 47,XXX | 47,XYY
Sophie van Rijn, PhDResearch aims - TRIXY National Center of Expertise47,XXY (KS) | 47,XXX | 47,XYY
Sophie van Rijn, PhDCognitive and behavioral development of children with 47,XXX: first results of the TRIXY study47,XXX
Susan Brasher, PhD, CPNP, RNWorkshop for Brothers and Sisters of those with an X or Y VariationAll
Virginia Cover, MSW, MBATransition to Work, Independence, & AdulthoodAll

2019 AXYS Family Conference Poster Presentations

Posters are in PDF Format

Poster

Relevant Variation

Association of Motor Skills with Adaptive Functioning in Children with 47,XXY Klinefelter and XXYY Syndrome47,XXY (KS) | 48,XXYY
Characterizing the Anxiety Phenotype in Trisomy X47,XXX
Developing a Model for the Transition from Pediatric to Adult CareAll
Early Therapies, School Supports, and Educational Outcomes for Students with Sex Chromosome VariationsAll
Executive Functioning of Children and Young Adults with an Additional X Chromosome47,XXY (KS) | 47,XXX
Exploration of Health Concerns and Needs for Care in Women with Trisomy X (47,XXX)47,XXX
Family Experiences and Attitudes About Receiving the Diagnosis of X & Y Chromosome Variations - Preliminary ResultsAll
Living with XXYY - Voices of Patients and Caregivers48,XXYY
NIMH Intramural Research Program Study of X- and Y-Chromosome VariationsAll
Relationship of Physical Function and Psychosocial Health on Quality of Life in Individuals with 48,XXYY - Preliminary Results48,XXYY
2019-07-19T11:49:21-04:00Tags: |

2013 AXYS Family Conference, Denver, CO

Session Presentation Slides

PRESENTER

SESSION TOPIC
Sharron Close, PhD Family Management Style and Diagnosis Disclosure in Klinefelter Syndrome: Preliminary Findings
Sharron Close, PhD Columbia University & Yale University – Research Update (Panel)
Sharron Close, PhD When Others Don’t Get It
Jackie Frazier, MA, SLP-CCC Speech-Language Intervention: Goals and Expectations, Early intervention through High School
Sydney Martin, MS OTR Occupational Therapy Treatment Across the age span
Phyllis Quatman; Gary Glissman Legal and Law Enforcement Issues
Rebecca Wilson, PsyD, Erin Gorman Bozorgpour, PhD, Jamie Blume, PsyD Behavioral Considerations for XY Chromosome Differences
Christa Hutaff-Lee, PhD Supporting the Development of Planning and Org Skills
R. Maria R. Ochoa, LCSW Strategic Planning & Resources for Crisis Prevention and Intervention
Pravin Rao, MD XXY and Fertility – and introduction to Johns Hopkins Klinefelter Syndrome Center
Ram Raj Singh, MD X/Y chromosome variations & Immune System Health
Ram Raj Singh, MD UCLA Research Update (Panel)
Phillip S Zeitler, MD PhD A Brief overview of endocrine issues in Klinefelter syndrome
Phillip S Zeitler, MD PhD Endocrine Issues Related to X and Y Chromosome Variations
Jeannie Visootsak, MD, FAAP Streams of Development and Behavior in XXY
Jeannie Visootsak, MD, FAAP Health and Development in XYY Syndrome
2024-09-06T15:12:50-04:00

2019 AXYS Family Conference Poster Presentations

2019 AXYS Family Conference Poster Presentations

The effects of androgen treatment on hippocampus structure and its association with spatial memory task performance in boys with Klinefelter syndrome: Vanessa Alschuler

The Relationship of Physical Function and Psychosocial Health on Quality of Life in Patients with 48,XXYY: Amy Blumling

Health Concerns of Women with Trisomy X: Sharron Close

47,XXYY Voices of Patients and Caregivers: Sharron Close

Family Attitudes and Experiences Receiving the Diagnosis of an X & Y Chromosome Variation: Sharron Close

The NIMH Intramural Research Program Study of X and Y Chromosome Variations: Kathleen Wilson

Executive functioning of children and young adults with an additional X chromosome: David J. Marcus and Phebe Albert, Georgia State University, Children’s Healthcare of Atlanta

Early therapies, school supports, and educational outcomes for students with X & Y variations: Preliminary results from a national survey: Talia Thompson, Susan Howell, Nicole Tartaglia

Eosinophilic Esophagitis Diagnosis in Patients with Sex Chromosome Aneuploidies: Susan Howell, C. Buchanan, H. Miyazawa, G. Furuta, N. Nguyen, Shanlee Davis, Nicole Tartaglia

The eXtraordinarY Babies Study: Preliminary Profile of Neurodevelopmental Skills at the 6 and 12-month visits in infants with Sex Chromosome Trisomy Identified by NIPT: Tanea Tanda, Nicole Tartaglia, Susan Howell, Shanlee Davis, Lisa Cordeiro, Judith Ross, Jennifer Janusz, Talia Thompson, Mariah Brown, C. Harrison, Rebecca Wilson

Association of Motor Skills with Adaptive Functioning in Children with XXY and XXYY Syndromes: Syd Martin, Lisa Cordeiro, P. Richardson, Shanlee Davis, Nicole Tartaglia

Exploring Neuropsychological Skills and Emotion Recognition in Males with XXYY Syndrome: Sophie van Rijn, Nicole Tartaglia, Susan Howell, Lisa Cordeiro, Hillary Weinpahl

Exploring preliminary relationships with adaptive functioning in girls with Trisomy X: Lisa Cordeiro, Kristen Wigby, Kathleen Angkustsiri, Nicole Tartaglia

Characterizing the Anxiety Phenotype in Triple X Syndrome: Rebecca Wilson, Kristen Wigby, Nicole Tartaglia

Evidence for Diminished Ovarian Reserve in Youth with Trisomy X: Nicole Tartaglia, Shanlee Davis, S. Dovey, E. Byers

Effects of Testosterone on Executive Function in Adolescents with Klinefelter Syndrome: Nicole Tartaglia, C. Harrison, Jennifer Janusz, Lisa Cordeiro, Susan Howell, Tanea Tanda, L. Pyle, Richard Boada

Fatness and Fitness in Adolescent Males with Klinefelter Syndrome: Shanlee Davis, G. Coe, A. Herstic, Nicole Tartaglia, Philip Zeitler, K. Nadeau

A Short Course of Testosterone in Infants with 47,XXY Klinefelter Syndrome has Acute Effects on Body Composition: Shanlee Davis, R. Reynolds, Syd Martin, Susan Howell, N. Nokoff, Philip Zeitler, Nicole Tartaglia

Testicular Function in Boys with 47,XYY: Shanlee Davis, Karen Kowal, A. Tahsin, Judith Ross

Adult Specialty Clinics for Sex Chromosome Aneuploidy: A WITH Foundation Grant to AXYS to support development of two pilot models at AXYS Clinic & Research Consortium clinic sites: Ginnie Cover, Carol Meerschaert, Robert Miller, Susan Howell, Nicole Tartaglia, Sharron Close, Amy Talboy

2025-07-11T09:47:23-04:00

Oxandrolone Treatment Results in Increased Risk of Gonadarche in Prepubertal Boys With KS (early testosterone use)

Article Title: Oxandrolone Treatment Results in an Increased Risk of Gonadarche in Prepubertal Boys With Klinefelter Syndrome

Authors: Shanlee M. Davis, Najiba Lahlou, Matthew Cox-Martin, Karen Kowal, Philip S. Zeitler, and Judith L. Ross

Date of Publication: June 20, 2018

“Two years of Ox[androlone] treatment in prepubertal boys with KS results in an increased risk of early gonadarche, on average 2 years earlier than in [placebo]-treated boys. Ox did not affect serum concentrations of testicular hormones.”

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Social cognition and underlying cognitive mechanisms in children with an extra X chromosome: a comparison with autism spectrum disorder

Article Title: Social cognition and underlying cognitive mechanisms in children with an extra X chromosome: a comparison with autism spectrum disorder

Authors: S. van Rijn, L. Stockmann, G. van Buggenhout, C. van Ravenswaaij-Arts, and H. Swaab

Date of Publication: 2014

This 2014 paper by Dr. Sophie van Rijn is an excellent study on the Theory of Mind and “the reported social behavioral difficulties in individuals with an extra X chromosome include shyness, social withdrawal, social anxiety, social immaturity, difficulties in peer relationships, social impulsivity, communication difficulties, reduced social assertiveness and difficulties with ‘being sensitive and responsive to the feelings and rights of others.”

“Individuals with an extra X chromosome are at increased  risk for autism symptoms. This study is the first to assess theory of mind and facial affect labeling in children with an extra X chromosome.”

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2019-04-30T09:29:50-04:00Categories: 47,XXX (trisomy x), 47,XXY (Klinefelter), 48,XXXY, 48,XXYY|

Recent advances in managing and understanding Klinefelter syndrome

Article Title: Recent advances in managing and understanding Klinefelter syndrome

Authors: Priyanka Bearelly and Robert Oates

Date of Publication: January 28, 2019

“Klinefelter syndrome can present as a wide spectrum of clinical manifestations at various stages in life, making it a chromosomal disorder with no standardized set of guidelines for appropriate management. Understanding the genetic and hormonal causes of this syndrome can allow physicians to treat each patient on a more individualized basis. The timing of diagnosis and degree of symptoms can guide management. This report will provide an updated review of the clinical presentation at various stages in life and the implications for management.”

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2019-04-01T11:09:48-04:00Categories: 47,XXY (Klinefelter)|Tags: |
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