Age-dependent manifestations of the short telomere syndromes. A schematic telogram demonstrating the typical ranges of telomere length shortening by age of symptomatic disease onset. The threshold for clinically relevant telomere shortening is age and context dependent. Highlighted on top are the predominant manifestations in each of four age groups ordered by prevalence (primary, secondary, and tertiary). Telomere length displays a normal distribution in the population that is defined by the percentile lines labeled on the right. The telomere length is representative here of both total lymphocyte and granulocyte telomere lengths. Each dot represents one patient adapted from symptomatic patients included in Schratz et al.⁴  *“Mucosal strictures” is a general term that encompasses mucosal defects affecting multiple systems, including lacrimal duct stenosis, esophageal stenosis/strictures/webs, and urethral stenosis/stricture/phimosis. A-V, arteriovenous; synd., syndrome.