A 4-month-old boy with CAH was brought for follow-up. He was presented at 20 days of life with vomiting and failure to thrive. His 17 OHP was very high (>100 ng/ml). With hyperkalemia and hyponatremia and he was diagnosed as salt-losing CAH and started on Hydrocortisone and Fludrocortisone. He responded well to the treatment.
Currently, he is 4 moths old and growing normally with normal weight 5.2 kg and length (63 cm). He is on Hydrocortisone 5 mg/day in divided dose and 0.1mg Fludrocortisone. Latest investigations showed very low 17-OHP (less than 1mg/ml ) very low DHEAS (<5mcg/dl) and normal Electrolytes (Na=135, K=4.5) How to follow-up these children's? How to differentiate inadequacy of steroid replacement vs excess steroids? Kindly give any suggestions.
