Detalle Publicación


Management guidelines for disorders/different sex development (DSD)

Autores: Guerro-Fernandez, J.; Azcona San Julián, María Cristina; Barreiro Conde, J.; Bermudez de la Vega, J. A.; Carcavilla Urqui, A.; Castaño-Gonzalez, L. A.; Martos-Tello, J. M.; Rodriguez Estevez, A.; Yeste Fernández, D.; Martinez Martinez, L.; Martinez-Urrutia, M. J.; Mora Palma, C.; Audi Parera, L.
Título de la revista: ANALES DE PEDIATRIA
ISSN: 1695-4033
Volumen: 89
Número: 5
Páginas: 315.e1 - 315.e19
Fecha de publicación: 2018
Disorders of Sex Development (DSD) include a wide range of anomalies among the chromosomal, gonadal, and phenotypic (genital) characteristics that define sexual differentiation. At present, a definition as Different Sexual Development (DSD) is currently preferred. They originate in the pre-natal stage, are classified according to the sex chromosomes present in the karyotype. The known genetic causes are numerous and heterogeneous, although, in some cases, they may be secondary to maternal factors and/or exposure to endocrine-disrupting chemicals (EDCs). The diagnosis and treatment of DSD always requires multidisciplinary medical and psychosocial care. An aetiological diagnosis needs the interaction of clinical, biochemical (hormonal), genetic, imaging and, sometimes, surgical examinations. The treatment should deal with sex assignment, the possible need for hormone replacement therapy (adrenal if adrenal function is impaired, and with sex steroids from pubertal age if gonadal function is impaired), as well as the need for surgery on genital structures (currently deferred when possible) and/or on gonads (depending on the risk of malignancy), the need of psychosocial support and, finally, an adequate organisation of the transition to adult medical specialties. Patient Support Groups have a fundamental role in the support of families, as well as the interaction with professional and social media. The use of Registries and the collaboration between professionals in Working Groups