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Re: low uE3From: ATB28 (ATB28@aol.com)Tue May 5 08:09:16 1998
In a message dated 05/05/1998 5:58:31 AM Pacific Daylight Time, allen.gardner@utoronto.ca writes: << Please respond to these thoughts re low uE3 on MSS. There is a differential diagnosis: +18 and +21 should be flagged by the MSS report X-linked ichthyosis (steroid sulfatase (STS) defeciency) Smith-Lemli-Opitz syndrome Multiple sulfatase defeciency Congenital adrenal hypoplasia There may be others, so please fill in the gaps. >> Allen: Don't forget to include "normal outcome" on your differential diagnosis! I think most providers appreciate having a differential diagnostic list to work from, as well as some suggestions on possible follow-up diagnostic testing. However, I'd stay away from directing specific actions on your laboratory report. It's been my experience that most providers, given a differential, don't hesitate to call and speak to the lab or clinical directors on the phone if they have questions regarding what might be appropriate follow-up diagnostic options. We encouraged the collegial discussions with the providers who used our genetics lab at Einstein, but didn't want to bind a provider into a single clinical course of action. Be a resource. Allan T. Bombard, MD
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