Folks I really need some help here...My 6yo daughter genotyped as a non-classic, but her levels are ridiculously high. She stimulated to 12,400 on her stim test at one time, and her baseline 17-OHP was 2580 at one point. She has some virilization issues, including an enlarged clitoris, pubic hair, acne, and far too much interest in sexual matters. Her bone age is 8 years 10 months. She is not technically a salt-waster, but has craved salt--or seemed too--for quite some time. She has also, in the past, required fluid resuscitation for a lot of "minor" illnesses, which always seemed to turn into major ones. Not all illnesses mind you, but many of them...

The pediatric endo wants to move her from a total of 3.75mg of Cortef a day to 10-12.5mg and add in Florinef...He thinks the Florinef may help provide better control and will allow for a "lower" dose of Cortef overall--though 12.5mg does not seem low to me.

We had had her seen at the NIH last November, and they advised 10mg of Cortef per day, but didn’t think Florinef was necessary as she only had a small degree of virilization, and genotyped non-classic...

Does anyone have any thoughts for me on the Cortef dose or the addition of the Florinef in a non-classic CAH child? Thanks so much in advance...

Christine