title: Steroid hormone analysis in diagnosis and treatment of DSD: position paper of EU COST Action BM 1303 'DSDnet'.
abstract: Disorders or differences in sex development (DSD) comprise a heterogeneous group of conditions with an atypical sex development. For optimal diagnosis, highly specialised laboratory analyses are required across European countries. Working group 3 of EU COST (European Cooperation in Science and Technology) Action BM 1303 'DSDnet' 'Harmonisation of Laboratory Assessment' has developed recommendations on laboratory assessment for DSD regarding the use of technologies and analytes to be investigated. This position paper on steroid hormone analysis in diagnosis and treatment of DSD was compiled by a group of specialists in DSD and/or hormonal analysis, either from participating European countries or international partner countries. The topics discussed comprised analytical methods (immunoassay/mass spectrometry-based methods), matrices (urine/serum/saliva) and harmonisation of laboratory tests. The following positions were agreed upon: support of the appropriate use of immunoassay- and mass spectrometry-based methods for diagnosis and monitoring of DSD. Serum/plasma and urine are established matrices for analysis. Laboratories performing analyses for DSD need to operate within a quality framework and actively engage in harmonisation processes so that results and their interpretation are the same irrespective of the laboratory they are performed in. Participation in activities of peer comparison such as sample exchange or when available subscribing to a relevant external quality assurance program should be achieved. The ultimate aim of the guidelines is the implementation of clinical standards for diagnosis and appropriate treatment of DSD to achieve the best outcome for patients, no matter where patients are investigated or managed.
authors.affiliation: Division of Pediatric Endocrinology and DiabetesDepartment of Pediatrics, Christian-Albrechts-University, Kiel, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kulle
authors.affiliation: Academic Unit of Child HealthDepartment of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: N
authors.initials: N
authors.lastname: Krone
authors.affiliation: Division of Pediatric Endocrinology and DiabetesDepartment of Pediatrics, Christian-Albrechts-University, Kiel, Germany.
authors.forename: P M
authors.initials: PM
authors.lastname: Holterhus
authors.affiliation: Veterinary Clinic for ObstetricsGynecology and Andrology of Large and Small Animals, Justus-Liebig-University, Giessen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schuler
authors.affiliation: School of Health and Biomedical SciencesRMIT University, Victoria, Australia.
authors.forename: R F
authors.initials: RF
authors.lastname: Greaves
authors.affiliation: Department of Growth and ReproductionRigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Juul
authors.affiliation: Department of Clinical ChemistryErasmus Medical Center, Rotterdam, Netherlands.
authors.forename: Y B
authors.initials: YB
authors.lastname: de Rijke
authors.affiliation: Steroid Research & Mass Spectrometry UnitLaboratory for Translational Hormone Analytics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University, Giessen, Germany.
authors.forename: M F
authors.initials: MF
authors.lastname: Hartmann
authors.affiliation: Department of SurgicalMedical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Saba
authors.affiliation: Pediatric Endocrinology and DiabetologyChildren's Hospital, University of Luebeck, Luebeck, Germany.
authors.forename: O
authors.initials: O
authors.lastname: Hiort
authors.affiliation: Steroid Research & Mass Spectrometry UnitLaboratory for Translational Hormone Analytics, Division of Pediatric Endocrinology and Diabetology, Center of Child and Adolescent Medicine, Justus-Liebig-University, Giessen, Germany.
authors.forename: S A
authors.initials: SA
authors.lastname: Wudy
mesh_terms: D058489:46, XX Disorders of Sex Development / Q000175:diagnosis / Q000235:genetics; D058531:46, XX Testicular Disorders of Sex Development / Q000175:diagnosis / Q000235:genetics; D012734:Disorders of Sex Development / Q000175:diagnosis* / Q000235:genetics; D005060:Europe; D005260:Female; D006728:Hormones / Q000032:analysis* / Q000235:genetics*; D006801:Humans; D008297:Male; D013256:Steroids / Q000032:analysis*
chemical_list: D006728:Hormones; D013256:Steroids