Letters Klinefelter’s syndrome

Diagnosis of Klinefelter’s syndrome is confounded by obesity

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f515 (Published 30 January 2013) Cite this as: BMJ 2013;346:f515
  1. Andrew J Hartland, bariatric physician1,
  2. Amir Khan, consultant surgeon1,
  3. Salman Mirza, locum consultant surgeon1,
  4. Matthew Orton, medical student2
  1. 1Walsall Healthcare NHS Trust, Walsall WS2 9PS, UK
  2. 2Liverpool University School of Medicine, Liverpool, UK
  1. Andrew.Hartland{at}walsallhospitals.nhs.uk

Blevin and Wilson’s article reminds us that the diagnosis of Klinefelter’s syndrome is often missed.1 On important reason for this is that, in our increasingly obesogenic environment, the classic physical description of tall slender body habitus is often not met—many patients have general and abdominal obesity. When the metabolic syndrome is found with Klinefelter’s syndrome (33-46% of cases), this is associated with abdominal obesity.2 3 4 In some series, patients with Klinefelter’s syndrome had a body mass index (BMI) as great as 60.6.2

The mean weight of patients in recent cases at our hospital was 143.3 kg (316 lb; BMI 44.6).

Even in the original series of nine cases published in 1942, the habitus is described, not as slender, but as “pear shaped . . . in the form of fashion a woman might have.”5


Cite this as: BMJ 2013;346:f515


  • Competing interests: None declared.