Hi all...
My 6yo daughter has genotyped as non-classic, but always presented as closer to simple virilizing as far as labs went. She had some very mild benital virilization, but nothing that would be considered grossly abnormal, pubic hair, and lots of acne from age 3 on. No diagnosis til she was 5 and 1/2...Anyway. She has been on treatment now since last November--10mg total of Cortef per day, with the possibility of adding in Florinef if her PRA comes back high. She has done nothing but gain weight from the Cortef, and has went from a quiet, sweet, mild-mannered little girl, to a frantically hyperactive one. Additionally, she is quite obviously not suppressed. Her acne is getting worse, and...She asked me to look at her bottom yesterday because it was itching, and I saw her clitoris. It is very enlarged. It really looks quite abnormal now.
So what are we supposed to do?? If we increase the Cortef, I foresee further problems with weight gain and hyperactivity. If we don't--well, I see where that's going. Could we dose differently? Currently we're doing 3.75mg in the AM, 2.5mg in the afternoon, and 3.75mg at bedtime. Should we consider 5mg around 1am, 3.75mg around 9am, and 1.25mg in the afternoon?? I read in the CAH Parent's book that for difficult to suppress children twice daily dosing will often work...? Anyone know about that? Is there any other things I can do here? Any advice is greatly appreciated.
Christine
