Health Care Providers in Digestive Health

Leadership – Who We Are – General Preventive Medicine Residency Program – Academics – Johns Hopkins Bloomberg School of Public Health

Health Care Providers in Digestive Health | Johns Hopkins Medicine

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Clarence Lam, MD, MPH serves on faculty and as the program director of the preventive medicine residency program at the Johns Hopkins Bloomberg School of Public Health.

Lam is a Phi Beta Kappa graduate of Case Western Reserve University where he completed his Bachelor of Arts in political science and biology. He earned his medical degree from the University of Maryland and his Master of Public Health from Johns Hopkins University.

He completed his residency training at Johns Hopkins, where he also served as chief resident, and is board-certified in preventive medicine.

In November 2014, Clarence Lam was elected to serve as a state delegate representing District 12, which includes both Howard and Baltimore Counties, in the Maryland General Assembly, where he currently serves on the House Environment and Transportation Committee. He is one of only four physician-legislators currently in the Maryland General Assembly.

While in medical school, Lam was elected as the student-body president of the University of Maryland, Baltimore, and he interned on the health affairs staff of the Committee on Oversight and Government Reform of the U.S.

House of Representatives where he assisted oversight investigations on drug safety policy. He also served as a biodefense analyst at the Center for Biosecurity of the University of Pittsburgh Medical Center and authored several publications on public health preparedness.

From 2009-2014, he served on the legislative staff of Delegate Dan Morhaim, MD in the Maryland General Assembly.

Clarence Lam is involved in many community organizations and serves on several non-profit boards of directors, including Healthy Howard, Unified Community Connections (formerly the United Cerebral Palsy of Central Maryland), and as board chair of the Community Action Council of Howard County, which manages the county’s food bank, Head Start program, and provides for energy and housing assistance to residents in need. He was a past appointee to the Governor’s Commission for Asian Pacific American Affairs and to Howard County’s Spending Affordability Advisory Committee.

Clinical Director

Kimberly Gudzune, MD MPH, FTOS is board-certified in Internal Medicine, a diplomat of the American Board of Obesity Medicine, and a Fellow of The Obesity Society. She received her bachelor’s degree in environmental biology from the University of Colorado.

She attended Tulane University in New Orleans, Louisiana, where she received her doctor of medicine and master of public health degrees. She completed her training in internal medicine at the University of Maryland Medical System.

After residency, she completed a clinical research fellowship within the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. She joined the faculty of the Johns Hopkins University School of Medicine as an Assistant Professor in 2012.

She currently practices as an obesity medicine specialist at the Johns Hopkins Digestive Weight Loss Center.

Gudzune’s research focuses on obesity, specifically how patient obesity influences the healthcare experience, the efficacy of commercial weight-loss programs, and how features of the built and social environment influence diet and exercise habits among low-income urban populations.

Her research has won several awards, in addition to being featured by news outlets including The New York Times and National Public Radio. She has been recognized for her outstanding mentoring of trainees with the 2015 Frederick L. Brancati Excellence in Mentoring Award at Johns Hopkins.

Gudzune joined the Preventive Medicine Residency in 2018 as Clinical Director.

Academic Directors

Elham Hatef, MD, MPH serves as faculty at the Center for Population Health IT (CPHIT) in the Department of Health Policy and Management and as the academic director of the Johns Hopkins General Preventive Medicine Residency Program.

As the academic director of the program she provides training and mentorship to the residents throughout their residency.

She earned her medical degree from Tehran University of Medical Sciences, in Tehran, Iran and her Master in Public Health from Johns Hopkins Bloomberg School of Public Health (JHSPH).

  Hatef completed a preliminary year in Internal Medicine at Yale-affiliated Griffin Hospital in Connecticut and Preventive Medicine Residency and Chief Residency at JHSPH. She then completed Clinical Informatics Practice Pathway at JHBSPH.  Hatef is board certified in Preventive Medicine-Public Health and Clinical Informatics.

Her main field of interest is population health, social determinants of health and health information technology. She studies the impact of social determinants of health on health-related outcomes using health IT and Big Data. She is involved in a number of projects in this area.

At CPHIT she has served as the project leader on the development of population health framework and measurements for Maryland, a collaboration with CRISP (Chesapeake Regional Information System for our Patients) supported through Maryland State Improvement Model and Centers for Medicare and Medicaid Services.

She also led the project to incorporate relevant available community/population level data sources into the Veterans Health Administration (VHA)'s electronic health records.

This project aimed to evaluate the health outcomes such as hospitalization rate at the primary care level while addressing social determinants of health.

In addition, in collaboration with other faculty at CPHIT she works on new methods of data mining and natural language processing to address social determinants of health using structured and non-structured electronic health records (EHR) data and publicly available population level data such as U.S. Census.

 Mary Carol Jennings, MD is a board-certified physician in Public Health and General Preventive Medicine and holds faculty appointments with the International Health Department and General Preventive Medicine Residency (GPMR) of the Johns Hopkins Bloomberg School of Public Health.

She currently serves as co-investigator on a Jhpiego-lead study on the measurement of stillbirth and early neonatal mortality in Tanzania, and on a GPMR-lead study on the health behavior impact of an innovative lifestyle medicine initiative into community-based primary care in Baltimore.

Before joining the International Vaccine Access Center as the Project Director of the Rotavirus Accelerated Vaccine Introduction Network, she served as the Chief Resident of the Hopkins preventive medicine residency program, and has held multiple leadership roles in policy and advocacy with a variety of domestic and international health professional organizations and non-profits. She holds an MPH from the Johns Hopkins Bloomberg School of Public Health and an MD from the University of South Carolina.

Jennings’ research interests blend scientific inquiry with public health practice in the fields of health systems and community- and technology-informed approaches to improving maternal, neonatal and child health, with work experience in the U.S., Philippines, Kenya and Tanzania.

Her focus is to test new platforms to scale up vaccine access, to determine best practices for scaling up vaccine access in unstable health systems, to make the economic case with and for countries to invest in preventive medicine strategies such as equitable, sustainable vaccine access programs, and to define methodological, research-based frameworks for community-based health systems strengthening interventions, focused on maternal, neonatal and child health. 

Chief Resident 

Ryan D. Lang, MD, MPH serves on faculty in the Department of Health Policy and Management and is Chief Resident of the General Preventive Medicine Residency Program. Lang received his Bachelor of Science degree in Biochemistry from Oakwood University in Huntsville, Alabama, where he graduated summa cum laude.

During his time as an undergraduate, he became heavily involved in scientific research and was one of 16 students in the nation to be awarded a UNCF-Merck Undergraduate Science Research Scholarship in 2008. However, his desire to serve in the community inspired him to pursue a career in medicine.

He earned his medical degree at Vanderbilt University School of Medicine in Nashville, Tennessee and worked with fellow classmates to revive a student interest group in preventive medicine while there.

During both his undergraduate and medical school years, he also developed an extensive global health background and worked on projects in Jordan, Kenya, and South Africa.

After graduating from medical school, Lang completed internal medicine residency with special concentrations in urban health and primary care at the Johns Hopkins Hospital. He then completed a second residency in preventive medicine at the Johns Hopkins Bloomberg School of Public Health, where he also received his Master of Public Health degree.

During his time as a preventive medicine resident, Lang worked with co-residents and community members to facilitate weekly community culinary workshops and to support nutrition education within a local neighborhood in Baltimore. His involvement was highlighted in The Maryland Reporter and Johns Hopkins Medicine Dome newsletter.

In 2011, he was one of 10 individuals to receive a Future Leaders in Preventive Medicine grant from the American College of Preventive Medicine (ACPM) and attended his first ACPM conference as a medical student.

Lang was also one of 15 young Marylanders (and the only physician) selected to participate in the 2017 New Economy Maryland Fellowship Program from the Institute for Policy Studies, which provides training for individuals to advocate for a more equitable economy in Maryland.

He has a strong interest in health communications and has written several editorials and letters to the editor which have been published in periodicals such as The Washington Post, The Baltimore Sun, The Maryland Reporter, Johns Hopkins Medicine Biomedical Odyssey, and Hopkins Medicine Magazine.

He also completed a brief internship with the Medical Unit at ABC News in New York City.

He plans to work with programs focused on chronic disease prevention and health communication in urban communities.


Massachusetts General vs. Johns Hopkins: 6 key comparisons

Health Care Providers in Digestive Health | Johns Hopkins Medicine

Boston-based Massachusetts General Hospital and Baltimore-based Johns Hopkins Hospital are two of the most prestigious, high-ranking hospitals in the United States.

Both institutions are lauded for their commitment to education, research, innovation and clinical care. They have garnered global recognition and their brands are emblems of premier U.S. medicine. But when stacked side by side, how do Massachusetts General and Johns Hopkins compare?

Note: Becker's Hospital Review periodically compares the nation's best systems. This article compares Massachusetts General Hospital and Johns Hopkins Medicine. We recently published an article comparing Cleveland Clinic and Mayo Clinic. If you would to see a comparison of two systems, please email

1. Leadership

Johns Hopkins: Paul B. Rothman, MD, has served as the  dean of the medical faculty, vice president for medicine of The Johns Hopkins University and CEO of Johns Hopkins Medicine since July 2012. As dean and CEO, Dr. Rothman oversees both the School of Medicine and the Johns Hopkins Health System.

  • Dr. Rothman attended medical school at New Haven, Conn.-based Yale University and earned his medical degree in 1984.
  • He completed a medical residency and rheumatology fellowship at Columbia-Presbyterian Medical Center in New York City before joining the medical faculty of the Columbia University College of Physicians and Surgeons in 1986.
  • There, he also completed a postdoctoral biochemistry fellowship, studying immunoglobulin class-switch recombination. He eventually became Columbia's Richard J. Stock Professor of Medicine for Immunology and Microbiology and chief of the pulmonary, allergy and critical care division.
  • Prior to joining Johns Hopkins, Dr. Rothman served as head of internal medicine at the Carver College of Medicine at the University of Iowa in Iowa City, a role he held for four years.

Massachusetts General Hospital: Peter L. Slavin, MD, has served as president of MGH since 2003.

  • Dr. Slavin graduated from Harvard College in Cambridge, Mass., in 1979. He earned a medical degree from Harvard Medical School in 1984 and an MBA from Harvard Business School in 1990.
  • He completed his training in internal medicine at Massachusetts General from 1984 to 1987, eventually being appointed senior vice president and CMO, a role he filled from 1994 to 1997.
  • Prior to his current role, Dr. Slavin served as president of Barnes-Jewish Hospital in St. Louis, Mo., from 1997 to 1999.
  • In addition to his duties at the helm of MGH, Dr. Slavin teaches internal medicine and healthcare management at Harvard Medical School, where he is a professor of healthcare policy.

 2. System size

Johns Hopkins, founded in 1889, is an integrated global health enterprise that operates six hospitals, four suburban healthcare and surgery centers, and 39 primary care and specialty care outpatient sites. It also offers the Johns Hopkins U.S.

Family Health Plan, a managed care program developed by the Department of Defense. The USFSP offers comprehensive healthcare benefits to members of the U.S.

' seven uniformed services, including active-duty family members, retirees and their family members and survivors.

  • Number of employees: As of Jan. 1, there are 41,000 combined full-time equivalent employees in the Johns Hopkins Medicine system, which includes facilities in St. Petersburg, Fla., Columbia, Md., Washington, D.C., and Bethesda, Md., in addition to its Baltimore locations. There are 1,950 full-time attending physicians at The Johns Hopkins Hospital, the system's flagship hospital, 625 attending physicians at Johns Hopkins Bayview Medical Center in Baltimore and more than 2,260 active medical staff across its other hospitals.
  • Number of beds: The Johns Hopkins Hospital houses 1,192 licensed beds. Combined, the system has 2,816 licensed beds.
  • Number of hospital visits: In 2015, there were more than 115,000 hospital admissions, more than 360,000 visits to the emergency department and upwards of 2.8 million outpatient visits across the total enterprise.

Massachusetts General Hospital opened its doors in 1811. It is the third oldest hospital in the U.S. and today operates five multidisciplinary care centers known worldwide for innovations in cancer, digestive disorders, heart disease, transplantation and vascular medicine.

  • Number of employees: MGH's main campus and four health centers in Charles, Chelsea, Revere and North End, Mass., employs 24,877 workers, including 2,405 physicians.
  • Number of beds: MGH's facilities house 999 licensed hospital beds.
  • Number of hospital visits: the health system admitted 50,679 inpatients and handled nearly 1.5 million outpatients in 2015. Annually, MGH records more than 100,000 emergency room visits, performs more than 42,000 operations and delivers more than 3,600 babies per year.

3. Affiliations

John Hopkins has numerous strategic affiliations, including those with Anne Arundel Health System, the Greater Baltimore Medical Center and Good Samaritan Hospital in Baltimore.

It also has international affiliations in Brazil, Chile, India, Japan, Lebanon, Panama, Peru and Turkey. It has joint ownership with hospitals in Saudi Arabia and Singapore, and strategic collaborative engagements in Canada, China, Colombia and Mexico.

Massachusetts General Hospital is a founding member of Boston-based Partners HealthCare, which has established regional dominance in the Boston region.

MGH has numerous partners, including Cooley Dickinson Hospital in Northampton, Mass., Martha's Vineyard Hospital in Oak Bluffs, Mass., and Nantucket (Mass.

) Cottage Hospital, as well as other affiliated healthcare providers in Maine and New Hampshire.

4. Academic medicine

Johns Hopkins. For the 35th consecutive year, in 2015 Johns Hopkins University was the leading U.S. academic institution in total research and development spending at more than $2 billion, according to the National Science Foundation's ranking.

The Johns Hopkins University School of Medicine was ranked No. 2 in funding from the National Institutes of Health of all U.S. medical schools in 2015, with more than $420 million in funding. In fiscal year 2015, there were more than 1,200 medical and doctoral students enrolled in the medical school, with more than 2,700 full-time and 1,300 part-time faculty.

Massachusetts General Hospital is the original and largest teaching hospital of Harvard Medical School, where nearly half of the hospital's staff physicians serve on the faculty.

With an annual research budget of more than $786 million, MGH conducts the largest hospital-based research program in the U.S., with a program that spans more than 20 clinical departments and centers across the hospital.

In fiscal year 2015, MGH was awarded a total of $352.92 million in funding from the NIH.

MGH offers 28 residency programs, 19 of which are accredited by ACGME. There are 851 residents, 866 doctoral students and a combined 1,380 research and clinical fellows at MGH.

5. Key financial statistics

Johns Hopkins: In fiscal year 2015, Johns Hopkins Medicine had net revenue of approximately $7.18 billion, $7 billion in operating expenses and a budgeted operating income of $182.3 million.

Massachusetts General Hospital: In fiscal year 2015, MGH had net revenue of $3.46 billion, $3.25 billion in operating expenses and $2.11 million in operating income.

6. National rankings

Johns Hopkins Hospital was ranked No. 3 in the nation and No. 1 in Maryland by U.S. News & World Report in its 2015-2016 Best Hospitals ranking. It is nationally ranked in 15 specialties, with nine in the top five and 11 in the top 10.

No. 1 — Rheumatology

No. 3 — Ear, nose and throat; neurology and neurosurgery; ophthalmology; and psychiatry

No. 4 — Urology

No. 5 — Diabetes and endocrinology, gastroenterology and GI surgery, and geriatrics

No. 6 — Cancer

No. 9 — Nephrology

No. 12 — Gynecology

No. 13 — Pulmonology

No. 16 — Cardiology and heart surgery

No. 20 — Orthopedics

Massachusetts General Hospital was ranked the No. 1 hospital in the nation by U.S. News & World Report in its 2015-2016 Best Hospitals rankings. Fifteen of the 16 specialties ranked by U.S. News were in the top 10 in the nation.

No. 1 — Ear, nose and throat

No. 2 — Diabetes and endocrinology; neurology and neurosurgery; and psychiatry

No. 3 — Gastroenterology and GI surgery

No. 4 — Geriatrics, gynecology, ophthalmology, orthopedics and pulmonology

No. 5 — Cardiology and heart surgery

No. 6 — Nephrology, rehabilitation and rheumatology

No.8 — Cancer

No. 16 — Urology

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U.S. list of Integrative Health Centers

Health Care Providers in Digestive Health | Johns Hopkins Medicine

University of Utah Health Care
Linda B. and Robert B.

Wiggins Wellness and Integrative Health Center at Huntsman Cancer Institute (HCI) – Salt Lake City  (ACIMH)
Offers a number of programs and services including acupuncture, cooking classes, massage therapy, mind-body skills group, nutrition counseling, outdoor fitness program, t'ai chi/qigong, yoga, and zumba classes.

Madsen Health Center, Integrative Medicine – Salt Lake CityOffers integrative consultation available to patients interested in looking at a particular health concern more closely and already have an established relationship with another primary care provider.

L.S. Skaggs Patient Wellness Center – Salt Lake City

Provides health and wellness programming for individuals in the community.

Cancer Wellness House(CSC) – Salt Lake City
“The Cancer Wellness House delivers evidence-based integrative holistic programs including yoga, massage, acupuncture, nutrition, exercise, spirituality, individual, group, social, and community support.” Fees are income.


The University of Vermont Health Network
Central Vermont Medical Center, Integrative Family Medicine – Montpelier
Offers primary care practice specializing in integrative family medicine. Provides services including management of acute & chronic illnesses, health maintenance examinations, diabetic education, acupuncuture, and rehabilitation therapies.

The University of Vermont Medical Center Wellness Resources – Burlington
Healthier Living Classes – Free workshops, which help people living with chronic illnesses learn techniques for reducing stress, getting a good night’s sleep, making informed treatment decisions, problem-solving, healthy eating, exercise and more.

Healthsource Classes – Offers FREE educational programs, healthy lifestyle classes and multi-week workshops.
MindBody Medicine Clinic (MBMC) Chronic Pain Program – Accepts patients with a spectrum of chronic pain types such as arthritis, joint pain, back and neck pain, headaches, neuropathic pain, pelvic pain and fibromyalgia.


Osher Center for Integrative Medicine at University of Washington School of Medicine
Coming in the summer of 2019, the Osher Center for Integrative Medicine Clinic, directed by Iman Majd, M.D., L.Ac. opens at the UW Neighborhood Ballard Clinic in Seattle.

Seattle Cancer Care Alliance – A Collaborative effort involving cancer specialists at Fred Hutch, Seattle Children's, and UW Medicine.
“Our integrative medicine providers have expertise in mind-body medicine, acupuncture and naturopathic medicine.

Our providers collaborate closely with SCCA providers from all Supportive Care disciplines, including medical nutrition, physical therapy, psychology/psychiatry, social work and spiritual health, to improve quality of life during all stages of cancer care and survivorship.

Classes for patients and caregivers at SCCA
Integrative Medicine 101 – Every 1st & 3rd Tues.

of the month, 9-9:45am at Patient and Family Resource Center, 3rd floor, SCCA South Lake Union clinic
Therapeutic yoga for cancer patients, caregivers and survivors – Mondays 3:30-4:45pm in conference room G6055, 6th floor, SCCA South Lake Union clinic and Thursdays from 12:30-1:45pm in conference room G3100, 3rd floor, SCCA South Lake Union clinic


Aurora Health Care
Aurora Wiselives Center for Wellbeing – Milwaukee  (ACIMH)Offers massage therapy, acupuncture, chiropractic care and family medicine.

A wide variety of classes and community events aimed at promoting health and wellness in eastern Wisconsin are offered through Aurora Health.

University of Wisconsin School of Medicine and Public Health
Integrative Health Program – Madison  (ACIMH)
Offers classes, programs, & services including acupuncture, healing touch therapy, inpatient services, integrative health physician consultations, massage therapy, Mindfulness-Based Stress Reduction, and integrative health & cancer care.


Gastro Center of Maryland

Health Care Providers in Digestive Health | Johns Hopkins Medicine

  • Rudy Rai, MD Dr. Rai was awarded the “TOP DOC” in Gastroenterology award by Baltimore Magazine for 2016.Dr. Rai is a Board Certified Gastroenterologist & Hepatologist, with over 22 years of experience in this field. He is the Medical Director of Gastro Center of Maryland & Cascades Endoscopy Center and has served on the Medical Faculty at Johns Hopkins University School of Medicine for many years, starting in 1997. He has been in many leadership positions in the Johns Hopkins Division of Gastroenterology & Hepatology, including as the Medical Director, Adult Liver Transplantation and Director, Clinical Effectiveness. He completed his Gastroenterology & Hepatology Fellowship at Johns Hopkins University in 1996 and completed an additional year of Advanced Fellowship at Johns Hopkins University in Transplant Hepatology and Biliary Disorders.Dr. Rai is considered a national thought leader and expert in the field of Gastroenterology and Liver disease and presents regularly at national and regional meetings. He has received many awards including Excellence in Clinical Research Award from the American College of Gastroenterology, Passano Clinician Scientist Award from Johns Hopkins University, Industry Research Scholar Award & Astra-Merck Award from the American Digestive Health Foundation, among others. He has published dozens of scholarly articles in peer-reviewed journals and authored many chapters for medical textbooks. He has performed over 50,000 procedures in this field and pioneered new and innovative medical techniques.
  • Eduardo Castillo, MD Eduardo Castillo, MD, is a board-certified physician, with specialties in both gastroenterology and hepatology. Dr. Castillo is committed to treating his patients with an exemplary level of care in a family atmosphere and is proud to offer his skills at the Gastro Center of Maryland located in Columbia and Olney, Maryland.Originally from Lima, Peru, Dr. Castillo received his medical degree from Lima’s prestigious Universidad Peruana Cayetano Heredia. He then traveled to Detroit, Michigan, for an internship, residency, and fellowship at the Henry Ford Hospital, where he served as chief medical resident of internal medicine and chief fellow for gastroenterology.Dr. Castillo has conducted a wide range of research on digestive issues, as well as liver cancer, cirrhosis, microscopic colitis, and peptic ulcer disease. In addition to being widely published, Dr. Castillo has presented his findings at national medical conferences. He’s also a member of the American Medical Association, the American Gastroenterological Association, and the American College of Gastroenterology, and is board-certified in internal medicine, gastroenterology, and hepatology.Dr. Castillo has a special interest in treating and preventing colon cancer, as well as treating hepatitis C, GERD, inflammatory bowel disease, and clostridium difficile infection.
  • Pia Prakash, MD Pia Prakash, MD, is a leading physician at the Gastro Center of Maryland in Columbia and Olney, Maryland. She is board certified in both gastroenterology and hepatology and is passionate abfering her patients personalized, compassionate care that meets their treatment goals.Dr. Prakash studied medicine at George Washington University School of Medicine in Washington D.C. After graduating, she completed a residency in internal medicine and a fellowship in gastroenterology, both at George Washington University. Dr. Prakash has also participated in a number of research studies, primarily focusing on colon cancer, inflammatory bowel disease (IBD), women’s health, and the impacts of celiac disease.Now at the Gastro Center of Maryland, Dr. Prakash treats a wide variety of conditions, including acid reflux, Crohn’s disease and ulcerative colitis, irritable bowel syndrome (IBS), celiac disease, colon cancer, hemorrhoids, and constipation. She also frequently treats acute and chronic liver disease. Dr. Prakash specializes in the use of capsule endoscopy in diagnosis, also known as PillCam®.
  • Josh Rosenbloom, DO Josh Rosenbloom, MD, is a board-certified physician, gastroenterologist, and hepatologist at the Gastro Center of Maryland in Columbia and Olney, Maryland. He is committed to providing his patients with the best possible personalized care in a calming and professional environment.Dr. Rosenbloom received his medical degree from Des Moines University. After graduating, he continued his medical education at the St. John Providence health system through Michigan State University, completing a residency in internal medicine and a fellowship in gastroenterology. He also participated in research on nutrition, weight loss, hepatitis C, and improving colonoscopy preparation. Dr. Rosenbloom specializes in offering colorectal cancer screenings, weight loss assistance, pain management, and nutrition.Now treating patients at the Gastro Center of Maryland, Dr. Rosenbloom is experienced in treating a wide array of gastrointestinal, liver, and pancreatic diseases. He most frequently treats acid reflux and GERD, irritable bowel syndrome (IBS), ulcerative colitis, Crohn’s disease, constipation, liver disease, celiac disease, among others.
  • Emily Almog
  • Monica Lovins
  • Elizabeth White, RN | Clinical Nurse Manager


Johns Hopkins Review of Medical and Surgical Gastroenterology

Health Care Providers in Digestive Health | Johns Hopkins Medicine

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Johns Hopkins Klinefelter Syndrome Center

Health Care Providers in Digestive Health | Johns Hopkins Medicine

From the 1889 opening of The Johns Hopkins Hospital, to the opening of the School of Medicine four years later, there emerged the concept of combining research, teaching and patient care. This model, the first of its kind, would lead to a national and international reputation for excellence and discovery.

Today, Johns Hopkins uses one overarching name—Johns Hopkins Medicine—to identify its entire medical enterprise.

This $5 billion system unites the physicians and scientists of the Johns Hopkins University School of Medicine with the health professionals and facilities that make up the broad, integrated Johns Hopkins Health System.

The Johns Hopkins Hospital and its affiliated hospitals and clinics has been ranked #1 by US News and World Report for the last 20 years. Its commitment to medical education, clinical care and research has made it one of the premier international institutions.

Mission: We are a comprehensive multidisciplinary health care system designed to care for boys and men with KS. Our medical specialists act as a team to provide the most up to date services to maintain the long-term health of men with KS.

The goals of the clinic are:

  • To be the premier center for the clinical care of men with sex chromosomal disorders
  • To develop standardized testing procedures for this population
  • To develop treatment guidelines for men with sex chromosomal disorders
  • To expand the scientific knowledge on the diagnosis, pathophysiology and treatment of the syndrome

Klinefelter syndrome is a group of conditions that affects the health of males who are born with at least one extra X chromosome. Chromosomes, found in all body cells, contain genes. Genes provide specific instructions for body characteristics and functions.

For example, some genes determine height and hair color. Other genes influence language skills and reproductive functions. Each person typically has 23 pairs of chromosomes. One of these pairs (sex chromosomes) determines a person’s sex. A baby with two X chromosomes (XX) is female.

A baby with one X chromosome and one Y chromosome (XY) is male.

Most males with Klinefelter syndrome, also called XXY males, have two X chromosomes instead of one. The extra X usually occurs in all body cells. Sometimes the extra X only occurs in some cells, resulting in a less severe form of the syndrome. This is called a mosaicism, and is very common. Rarely, a more severe form occurs when there are two or more extra X chromosomes.

What are the signs and symptoms of Klinefelter syndrome?

Signs and symptoms can vary. Some males have no symptoms but a doctor will be able to see subtle physical signs of the syndrome. Many males are not diagnosed until puberty or adulthood. As many as two-thirds of men with the syndrome may never be diagnosed. Many men with mosaicism for XXY males do not have all of the signs and symptoms listed below.

Infants and young boys may have:

  • Problems at birth, such as testicles that haven’t dropped into the scrotum or a hernia*
  • A small penis
  • Weak muscles
  • Speech and language problems, such as delayed speech
  • Problems with learning and reading
  • Problems fitting in socially
  • Mood and behavioral problems

Adolescents may ALSO have:

  • Small, firm testicles
  • Enlarged breasts, called gynecomastia
  • Long legs but a short trunk
  • Above-average height
  • Reduced muscle bulk
  • Sparse facial and body hair
  • Delayed puberty
  • Low energy levels

Adults may ALSO have:

  • Low testosterone (male hormone) levels
  • Infertility from a lack of sperm
  • Decreased sex drive
  • Problems getting or keeping an erection
  • Other difficulties, such as being unable to make plans or solve problems

* when an internal organ bulges through a body cavity wall

How is Klinefelter syndrome diagnosed?

Diagnosis is a physical examination, hormone testing, and chromosome analysis. The syndrome can also be diagnosed before birth but testing is not routinely done at that time.

Health Problems Associated with Klinefelter Syndrome

Klinefelter syndrome can lead to weak bones (osteoporosis), varicose veins, and autoimmune diseases (when the immune system acts against the body), such as lupus or rheumatoid arthritis.

XXY males have an increased risk for breast cancer and cancers that affect blood, bone marrow, or lymph nodes, such as leukemia.

They also tend to have excess fat around the abdomen (which raises the risk of health problems), heart and blood vessel disease, and type 2 diabetes.

What is the treatment for Klinefelter syndrome?

Treatment can help males overcome many of the physical, social, and learning problems that are part of the syndrome. Males with Klinefelter syndrome should be seen by a team of health care providers.

The team may include endocrinologists, general practitioners, pediatricians, urologists, speech therapists, genetic counselors, and psychologists. Surgery may be needed to reduce breast size.

With treatment, men can lead very normal lives.

Experts recommend testosterone replacement, starting during puberty, for proper development of muscles, bones, male sex characteristics such as facial hair, and sexual function.

Continued treatment throughout life helps prevent long-term health problems. Testosterone replacement does not cure infertility, however.

Infertility treatments require specialized—and costly—techniques, but some men with Klinefelter syndrome have been able to father children.