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Case Reports
. 2019 Jun 26;32(6):643-646.
doi: 10.1515/jpem-2018-0567.

Utilization of a shared decision-making tool in a female infant with congenital adrenal hyperplasia and genital ambiguity

Affiliations
Case Reports

Utilization of a shared decision-making tool in a female infant with congenital adrenal hyperplasia and genital ambiguity

Reeti Chawla et al. J Pediatr Endocrinol Metab. .

Abstract

Background Shared decision-making (SDM) is the process by which patients/families and providers make healthcare decisions together. Our team of multidisciplinary disorders of sex development (DSD) has developed an SDM tool for parents and female patients with congenital adrenal hyperplasia (CAH) and associated genital atypia. What is new Elective genital surgery is considered controversial. SDM in a patient with genital atypia will allow patient/family to make an informed decision regarding surgical intervention. Case presentation Our patient is a 2.5-year-old female with CAH and genital atypia. Initially, her parents had intended to proceed with surgery; however, after utilizing the SDM checklist, they made an informed decision to defer urogenital sinus surgery for their daughter. Conclusions We successfully utilized an SDM tool with parents of a female infant with CAH and genital atypia, which allowed them to make an informed decision regarding surgery for their daughter. Future directions include a prospective enrolling study to determine the generalizability and applicability of SDM with families of children diagnosed with CAH.

Keywords: congenital adrenal hyperplasia; genital ambiguity; shared decision-making.

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References

    1. Almasri J, Zaiem F, Rodriguez-Gutierrez R, Tamhane SU, Iqbal AM, et al. Genital reconstructive surgery in females with congenital adrenal hyperplasia: a systematic review and meta-analysis. J Clin Endoc Metab 2018;103:4089–96.
    1. Speiser PW, Arlt W, Auchus RJ, Baskin LS, Conway GS, et al. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an endocrine society clinical practice guideline. J Clin Endocr Metab 2018;103:4043–88.
    1. Lee PA, Nordenstrom A, Houk CP, Ahmed SF, Auchus R, et al. Global disorders of sex development update since 2006: perceptions, approach and care. Horm Res Paediatr 2016;85:158–80.
    1. Hemesath TP, de Paula LC, Carvalho CG, Leite JC, Guaragna-Filho G, et al. Controversies on timing of sex assignment and surgery in individuals with disorders of sex development: a perspective. Front Pediatr 2018;6:419.
    1. Yankovic F, Cherian A, Steven L, Mathur A, Cuckow P.Current practice in feminizing surgery for congenital adrenal hyperplasia; a specialist survey. J Pediatr Urol 2013;9:1103–7.

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