P352 Disorders of sexual development in children – a problem solve only by a multidisciplinary team

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Abstract

Aim

Disordes of sexual development -DSD-is the reality of our daily practice.To solve this problem we must have a rational, professional and delicate atitude in the some times in order to get the best solution for the child future.

Material and methods

From 2000–2016 we analised the records and children admnited in the departemet of endocrinology and neonatology with different problems of DSD. We analised the injuiries during pregnancy, the consangvinity, aspects of genitalia and others clinical abnormality conected with DSD.We performed general and specific laboratory (hormons, cariotype, genes, etc ) and imaging anlises (xRay, urography, cistography, bone age, MRI, CT) in order to establish the diagnosis.We treat the child medical or surgical or both as the diagnois was done.

Results

During sixteen years we found a lot of 57 DSD, discovered in neonatal period but also in adolecents-at puberty.Unfortunately the proportion of DSD preasent at the seciund group of age was biger that descovered in the neonatal period. The DSD potofolium was complex :numerical chromosomal disorders 36 patients with different forms (45X, 47XXY, 45X/46XX); 46XYDSD (disgenetic gonads 2, disorders of syntesis and action of hormons1, non-classified DSD-hypospadias 9, bladder estrophy 2); 46XXDSD (androgen exces – 7, non-calsiffied Mayer Rokytansky sy −2 cases) the diagnosis was made by a team paediatric endocrinologist, neonatologist, genetic specialist,radiologist, surgeon and psihlog. The treatment was done accordind to the diagnosis and international guidelines.

Conclusions

1. The Proportion of DSD in paediatric pathology is incresed. 2. The diagnosis may be establish as soon as is possible in order to minaize the psychologic trauma of the child and family. 3.It is necessatry to mobilise all appropriate medical and economic resouses to establish a correct diagnosis. 4. It is necessary to cooperate with international data bases.

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