25
Physical Examination
Findings Screening Tests Confirmatory Tests
Signs of virilization
(11-beta-OH)
or incomplete
masculinization
(17-alpha-OH)
Hypertension and
hypokalemia with low or
normal aldosterone and
renin
11-beta-OH: elevated
DOC, 11-deoxycortisol,
and androgens; 17-alpha-
OH; decreased androgens
and estrogen but elevated
DOC and corticosterone
Arrhythmias (with
hypokalemia)
Low aldosterone and renin Urinary cortisol
metabolites; genetic testing
Acral features; large
hands and feet; frontal
bossing
Serum growth hormone
≥1 ng/mL during oral
glucose load
Elevated age- and sex-
matched IGF-1 level; MRI
scan of the pituitary
