Sandbox:Mehrian
Phenotype: Classic salt wasting Classic simple virilizing Nonclassic ♂ ♀ ♂ ♀ ♂ ♀ Age at diagnosis Newborn-6m Newborn-1m 2–4 y Newborn-2 y Child-adult Child-adult Genitalia Normal Ambiguous Normal Ambiguous Normal +/− ↑ clitoris Aldosterone ↓ Normal Normal Renin ↑ May be ↑ Normal Cortisol ↓ ↓ Normal 17-OH-progesterone >20,000 ng/dl >10,000–20,000 ng/dl 1,500–10,000 ng/dl (ACTH-stimulated) Testosterone ↑ In pre-puberty only ↑ ↑ In pre-puberty only ↑ Variably ↑ in pre-puberty only Variably ↑ Treatment Glucocorticoid+ mineralocorticoid (+ sodium) Glucocorticoid (+ mineralocorticoid) Glucocorticoid, if symptomatic Somatic growtha -2-3 sd, husky-obese -1-2 sd ?-1 sd Incidenceb 1/20,000 1/60,000 1/1000 Typical mutationsc Deletion I172N V281L Large conversion nt 656g P30L nt 656g (“intron 2 g”) G110Δ8nt I236N/V237E/M239K Q318X R356W % Enzymatic activityd 0 1 20–50