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What is A 3 week neonate with ambiguous genitalia presented with Na+ 127 meq/L, K+ 7.2 meq/L wit BP 52/24 mm Hg and he was managed with IV fluids. What is the next step of management? and explain in detail?
Karyotype 46 XX Physical appearance - male pattern Precocious pubey at 2-4 yrs. of age. Uterus, cervix and fallopian tubes are present (bcz 44 XX) - Mullerian duct development is normal. Metabolic problems: Hyponatremia - aldosterone deficiency Hyperkalemia Hypotension Diagnosis: 1) USG Normal 2) Barr body present 3) Biochemistry - 17 hydroxyprogesterone || > 800 ngm/dl. Management: DOC - Dexamethasone - to pregnant women and fetus both having CAH. Hydrocoisone - pregnant women alone having CAH but fetus is normal. Neonate with CAH. Labioscrotal folds may be separated to folds may be fused at the midline, giving an appearance of a scrotum Labioscrotal folds with increased pigmentation suggest the possibility of increased coicotropin levels as pa of adrenogenital syndrome