CONCLUSION
Classic congenital adrenal hyperplasia, although rare, can present with
a devastating picture of hypoglycemia and salt-wasting crisis as seen in
this case. Although female patients present with signs of virilization,
this male child presented with hyperpigmentation of his genitalia with
additional concerns of failure to thrive. There is an increased risk for
cognitive impairment as a consequence of the presentation seen with this
disorder and thus timely diagnosis and management are crucial. This case
highlights the need for neonatal screening for the CAH which is
currently not a mandatory practice in some countries. Early diagnosis
through screening at birth can contribute to better outcomes and
prognosis.