Turner Syndrome Program

Who we are

The multi-disciplinary Turner Syndrome Program at Women’s College Hospital is unique in Canada. We provide multi-disciplinary care to adult women with Turner Syndrome and we ensure that all Turner specific screening and care are delivered. Women attending the clinic are seen by both an endocrinologist (ie. Hormone/metabolism specialist) and a gynecologist at every clinic visit. Additionally, we work closely with the cardiology department at Women’s College Hospital to ensure optimal cardiac screening and management.

At the clinic visit, we address all relevant medical and gynecological needs and arrange referrals to other specialties as necessary. We provide recommended Turner Syndrome-specific screening including heart, bone density and hearing testing as well as blood tests for diabetes, cholesterol, liver, thyroid and celiac disease.

Who we serve

We see all adult women with Turner Syndrome on an annual basis. However, closer follow up is provided for women who require it.

Our Team

Iliana Lega, MD, MSc, FRCPC headshotDr. Iliana Lega

Dr. Lega is an endocrinologist at Women’s College Hospital, a scientist at Women’s College Research Institute and an Assistant Professor at the University of Toronto. Dr. Lega has a special inter

est in the care of adult women with Turner Syndrome and she leads the clinical and research program for Turner Syndrome at Women’s College Hospital. She is conducting multiple ongoing studies that seek to evaluate ways to improve the quality of care delivered to women with Turner Syndrome so as to optimize healthcare outcomes for adult women with Turner Syndrome.

headshot of Dr. Lisa AllenDr. Lisa Allen

Dr. Allen is a Professor in the Department of Obstetrics and Gynecology at the University of Toronto. She is a Gynecologist and Minimally Invasive Surgeon at Women’s College Hospital and Sinai Health System. She is the Section Head of Paediatric and Adolescent Gynecologist at Sickkids Hospital. Dr. Allen specializes in the care of individuals with variations in sexual and reproductive development. Along with Dr. Cathy Kelly from endocrinology, she recognized the need for women with Turner syndrome to benefit from multidisciplinary care, as a result, they co-led the development of a combined program with gynecology and endocrinology at Women’s College Hospital. She remains the gynecology lead, of the Turner Syndrome Program at Women’s College Hospital. She is collaborating on research on sexual and reproductive health in women with Turner syndrome.

Dr. Kathy Kelly

Dr. Kelly is an endocrinologist at Women’s College Hospital and a Professor of Medicine in the Department of Medicine at the University of Toronto. Dr. Kelly started seeing women with Turner Syndrome in the early 1990s to monitor for thyroid disease and the development of diabetes and began to coordinate and manage more substantial surveillance for all of the medical issues key to the follow up of women with Turner Syndrome. She developed some close collaboration with the Turner Syndrome Program at the Hospital for Sick Children. It was clear from the medical literature at the time, that many women did not receive all the appropriate medical surveillance once they graduated from more coordinated programs in pediatrics. Together with Dr. Allen, they organized a coordinated Turner Syndrome clinic where they would work together in one clinic visit that would be housed at Women’s College Hospital. Dr. Kelly is involved in the research in the Turner Syndrome Program to monitor medical outcomes, healthy lifestyle practice, development of diabetes, and symptoms associated with different hormonal treatments. Dr. Kelly has spoken several times at the Turner Syndrome Society Annual Meetings.

Dr. Michelle Jacobson

Dr. Michelle Jacobson is a general OBGYN and menopause specialist at Women’s College and Mount Sinai Hospitals in Toronto. She has a special interest in women who are prematurely menopausal due to Turner Syndrome, cancer therapies or women with hereditary breast and ovarian cancer syndromes. She works in the Turner Syndrome Clinic and directs the Familial Ovarian Cancer Clinic at Women’s College Hospital. She is an Assistant Professor in the Department of Obstetrics and Gynecology at the University of Toronto. Her current research involves the long term use of hormone therapy in women with Turner Syndrome as well as exploring the reasons women change their hormone therapy regimens in Turner Syndrome.

 

Dr. Paula Harvey headshotDr. Paula Harvey

Dr. Harvey is Physician-in-Chief at Women’s College Hospital, a scientist at Women’s College Research Institute, and Co-Director of the Cardio-Rheumatology Program at Women’s College Hospital. Dr. Harvey’s research focus is on cardiovascular disease in women, with a special interest in hypertension, lifestyle interventions including cardiac rehabilitation and cardiovascular disease in patients with autoimmune and rheumatologic diseases. Dr. Harvey’s research explores how blood pressure and the health of blood vessels are regulated by the body – and how this system of regulation may differ between women and men. She is also interested in the role of inflammation in autoimmune diseases in the development of cardiovascular disease.

Dr. Shadi Akhtari headshotDr. Shadi Akhtari

Dr. Akhtari is a cardiologist at Women’s College Hospital and an Assistant Professor at the University of Toronto. Dr. Akhtari graduated from Queen’s University School of Medicine in 2006 and has completed further specialty and subspecialty training in Internal Medicine, Cardiology, and adult echocardiography at McGill University, followed by a fellowship in Cardiovascular Magnetic Resonance Imaging at Harvard Medical School. Dr Akhtari specializes in advanced cardiac imaging and has a special interest in cardiovascular risk stratification in Turner Syndrome. Dr. Akhtari is involved in research projects related to improving cardiac screening modalities and cardiovascular risk factors in women with Turner Syndrome.

 

headshot of Dr. Tosin OsuntokunDr. Tosin Osuntokun

Dr. Osuntokun obtained her medical degree, with honours, from the Royal College of Surgeons in Ireland and went on to complete her internal medicine and cardiology training in Ireland. As part of her training in Ireland, she subspecialised in inherited cardiac conditions and cardiac disease in young adults which involved a multidisciplinary approach to family evaluations including the use of multimodality imaging. Subsequently, she did a further clinical fellowship in non-invasive cardiology and inherited cardiac conditions at Guy’s and St. Thomas’ Hospitals in London, UK. She has completed fellowships in general ambulatory cardiology as well as heart disease in women at Women’s College Hospital in Toronto. This involved working with patients who have Turners syndrome and cardiovascular disease. She is currently doing a subspecialty clinical fellowship at Women’s College Hospital in dysautonomia and disorders of blood pressure control.

Ms. Eunice Cauzo, RPN

Ms. Cauzo is a Registered Practical Nurse who works in the Turner Syndrome Clinic. She has 5 years of experience providing clinical care and finds her work in the Turner Syndrome clinic extremely rewarding. She aims to provide a holistic care experience by investing the time to effectively address patients’ concerns and needs. Ms. Cauzo’s role involves coordinating patient care, providing therapeutic nursing care, and addressing patients’ health concerns. Her responsibilities include performing basic health assessments (i.e., height, weight, blood pressure measurements) updating medical histories, and communicating with patients about results and appointments.

Bio coming soon…

Turner Syndrome Program

Women’s College Hospital
76 Grenville Street
Floor 5
Toronto, ON M5S 1B2

Phone: 416-323-7744
Fax: 416-323-6237
Referral Fax: 416-323-6330 – Access Centre

Hours of Service

Two half-day clinics per month

Referrals

How to refer a patient

Patients are seen only by referral from a family doctor, other specialist or nurse practitioner.

Please send a referral to fax number 416-323-6534 with the following information

  1. Your name, billing number, contact information
  2. Preference for a specific program, endocrinologist if applicable.
  3. Patient demographic and contact information
  4. Reason, urgency for referral
  5. Past medical history/cumulative patient profile
  6. Medication list
  7. Relevant recent investigations, e.g.:
  8. HbA1c for diabetes
  9. TSH for thyroid disorder
  10. Thyroid ultrasound for thyroid nodule
  11. DEXA report for osteoporosis

Booking an Appointment

Currently, we accept referrals to our clinic for women with Turner Syndrome. Please ask your physician to complete a patient referral form and have them fax it to our clinic at 416-323-6330.

Preparing for Your First Visit

In order to best serve you, we request that you prepare and bring the following to your first visit:

  • A list of medications you are currently taking with the full names and doses
  • A list of doctors and hospitals who’ve helped managed your care
  • Questions to ask your healthcare provider

What to Expect at Your First Visit

The Turner Syndrome Clinic is on the 5th floor of Women’s College Hospital. Please aim to arrive 5-10 minutes before your clinic so as to have adequate time to check in. When you arrive at the 5th floor, please check in at the registration desk.

During the first visit, a registered nurse will measure your blood pressure, weight, and height. The nurse will also conduct a general medical intake. The medical team will conduct a comprehensive assessment which will involve reviewing your full medical history and conducting a physical exam (30-45 minutes). Since we are an academic teaching hospital, you may be seen by both learners and the staff physicians.

After the visit, you may be requested to go to the Lobby Lab for a non-fasting blood test.

Resources