Klinefelter syndrome was first described in 1942 by Dr Harry Klinefelter and colleagues. It is a chromosomal abnormality that only occurs in 1 in 500 to 1,000 newborn boys. A female usually has an XX pair of sex chromosomes and a male an XY pair. Klinefelter syndrome occurs due to an extra copy of the X chromosome in males.
Medical text written November 1991 by Contact a Family. Approved November 1991 by Professor M Patton, Professor of Medical Genetics, St George’s Hospital Medical School, London UK and Dr JE Wraith, Consultant Paediatrician, Royal Manchester Children’s Hospital, Manchester, UK. Last updated March 2012 by Dr R Stanhope, Consultant Paediatric Endocrinologist, The Portland Hospital, London UK.
The most common symptom is infertility. Other symptoms include abnormal body proportions (long legs, short trunk, shoulder equal to hip size), less than normal amount of pubic armpit and facial hair, small, firm testicles, reduced muscle and tall stature. Breast development may appear after puberty in 25 per cent of those affected. In some cases, intellectual difficulties, especially in verbal skills, may be experienced. Additionally psychological problems with self-image may be experienced by adolescent boys and adult men.
Other chromosome abnormalities involving more than two X chromosomes in males may lead to more severe learning difficulties.
Males affected by Klinefelter syndrome have two X chromosomes, as well as one Y, resulting in the formation XXY. A mosaic form also occurs where only a percentage of body cells contain XXY while the remainder carry XY. The extent of the affect will depend upon the proportion of XXY to XY throughout the body. Males with Klinefelter syndrome typically have small testes that do not produce enough testosterone, which is the hormone that directs male sexual development before birth and during puberty.
Klinefelter syndrome may first be diagnosed when a man comes to the doctor because of infertility, as it is the most common symptom. Examining sex chromosomes to determine number (karyotyping) can confirm the diagnosis. It may also be necessary to test hormone levels, including estradiol (a type of oestrogen), follicle stimulating hormone, luteinising hormone and testosterone.
Boys diagnosed with Klinefelter syndrome may benefit from speech and language therapy and other support to learn to express themselves. They may also benefit from educational support and occupational therapy to increase muscle tone. Testosterone therapy may be prescribed to help grow body hair, improve appearance of muscles, improve mood and self-esteem, increase energy and sex drive and increase strength.
Most men with this syndrome will be unfertile so referral to a fertility specialists for advice may be required. In some cases, surgical microdisection of the testes may reveal sperm and allow fertility using intracytopalsmic sperm inoculation or of an egg and in vitro fertilisation.
Klinefelter syndrome usually occurs as a sporadic event. Women who get pregnant after age 35 years are slightly more likely to have a boy with this syndrome than younger women.
Chorionic villus sampling at 10 to 12 weeks or amniocentesis at about 16 weeks is available to older mothers to determine if the child is at risk of Klinefelter syndrome.
Klinefelter Syndrome Association (KSA)
The Association is a Registered Charity in England and Wales No. 1058319. It provides information and support to all affected by, or having an interest in, Klinefelter’s Syndrome. The Association holds an annual conference and AGM in June and runs an activity weekend in spring and autumn.
Group details last updated November 2018.