Mechanism
Low cortisol, high ACTH, thus high androgen production
Androgens cause virilisation of the genitalia at birth (ambiguous genitalia)
Aldosterone may also be affected, causing salt wasting (vomiting, weight loss, hypotonia, circulatory collapse)
Androgens also cause initial tall stature then precocious puberty (BO, acne, body hair), then final restricted height due to early epiphyseal closure