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As explained in our article, Klinefelter syndrome (KS) is characterized by numerous comorbidities. These include cardiac disorders, which thus far have been seen mostly in association with the metabolic syndrome. The coincidence of KS and Wolff-Parkinson-White (WPW) syndrome, as described by Dr Niemann, seems to be a very rare event because WPW syndrome was not found in any of the 69 Italian patients with KS who underwent intensive cardiological investigations (1), nor was it described in any of the more than 500 patients in our institution, and, notably, it was not found in any of the specially cardiologically investigated subgroup of 132 patients. However, it should be pointed out that disorders of the heart and vasculature contribute to increased mortality in patients with KS.

Dr Spitczok von Brisinski expands on the section on psychological and neurological problems in boys with KS before puberty; we kept this short in our article for reasons of space. The literature he cites also complements the citations in the review article very appropriately. The letter re-emphasizes that KS should also be considered in children and adolescents with psychological and psychiatric abnormalities and thus supports the intentions of our review article.

DOI: 10.3238/arztebl.2013.0675c

Prof. Dr. med. Dr. h. c. Eberhard Nieschlag FRCP

Centrum für Reproduktionsmedizin und Andrologie, Universitätsklinikum Münster

Eberhard.Nieschlag@ukmuenster.de

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Pasquali D, Arcopinto M, Renzullo A, et al.: Cardiovascular abnormalities in Klinefelter Syndrome. Int J Cardiol 2012 [Epub ahead of print] CrossRef MEDLINE
2.
Nieschlag E: Klinefelter syndrome: the commonest form of hypogonadism, but often overlooked or untreated. Dtsch Arztebl Int 2013; 110(20): 347–53 VOLLTEXT
1.Pasquali D, Arcopinto M, Renzullo A, et al.: Cardiovascular abnormalities in Klinefelter Syndrome. Int J Cardiol 2012 [Epub ahead of print] CrossRef MEDLINE
2.Nieschlag E: Klinefelter syndrome: the commonest form of hypogonadism, but often overlooked or untreated. Dtsch Arztebl Int 2013; 110(20): 347–53 VOLLTEXT

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