The clinic offers appointments with the following specialists. All patients see the endocrinologist initially for a complete history and physical exam.
Adult Endocrinology (Adult Hormone Treatment) For males 18 and over:
Adrian Dobs, M.D.,M.H.S.
At the initial and to some extent the follow-up visits, men should expect a complete history and physical examination. We will ask questions about your medical history, such as when and how the diagnosis of KS was made and any direct treatments. We will discuss possible complications of KS such as bone health, sexual function and cognitive function. There will also be questions about family history and social situation, such as educational accomplishments and employment status. The physical exam is complete and will include an examination of the testes, since this is so important in this medical condition.
After the history and physical exam, we will discuss some of the basic medical concerns for men with Klinefelters and attempt to personalize the treatment recommendations. There is usually a conversation of the types of testosterone therapies available and which would be best for the individual patient. We also discuss fertility issues and long-term complications of the condition.
We usually order a series of blood tests to measure hormones and to evaluate you for any other medical problems. Often times a test is done to evaluate you for any bone disease. We discuss any other consultations that might be needed.
There is usually follow-up communication on the lab results which takes place via telephone or e-mail. Follow-up visits are usually in six months, and then every one to two years thereafter.
We see patients from all over the United States and find that this is very helpful in providing men with some basic recommendations going forward. We will work closely with any primary care or local endocrinologist. Please plan on a visit of at least two hours, which includes the laboratory tests.
Pediatrics (Childhood Treatment) For boys under 18 years of age
David Cooke, M.D.
At the initial visit, a complete history will be obtained and a physical examination performed. We will ask questions about the medical history, including when and how the diagnosis of KS was made. The examination will include the assessment of genital and pubertal development.
After the history and physical exam, we will discuss what to expect regarding the impact of KS during childhood, including how we personalize treatment recommendations. At all ages, we discuss the appropriate timing of developmental and psychoeducational testing. For infants, we discuss whether or not testosterone treatment is appropriate. In school age children we discuss what to expect regarding the onset of puberty. During puberty we discuss the appropriate timing for considering testosterone treatment, as well as issues surrounding fertility.
We may do blood tests in infants as part of an assessment of whether there would be a benefit of testosterone treatment. Visits during the school age years usually do not involve blood tests. Once puberty is started, blood tests are monitored to guide the decision about testosterone treatment.
If the diagnosis of KS is made either prenatally or soon after birth, we like to see the boys for a visit in the first months of life. We would subsequently have follow up visits at around 1 and 5 years of age. Once the boys are approaching adolescence (at 10 years of age or so), we will have follow up visits every 6 to 12 months. If the diagnosis of KS is made after infancy, we would typically have the first visit soon after diagnosis, with the timing of subsequent visits similar to that for boys diagnosed as infants.
We see patients from all over the United States. If desired, we are happy to work closely with a local pediatric endocrinologist. Please plan on a visit of at least one hours.
Dorota Hawksworth,M.A., M.B.A., M.D.
Urology (Infertility, Sexual function):
Amin S. Herati, M.D.
Biochemistry and Molecular Biology:
Phil Jordan, PH.D.
Gynecology and Obstetrics:
Cathy Lawson, M.S.
Neuropsychology (Problems with learning/thinking and/or mood):
Cynthia Munro, Ph.D.