Case Presentation: Patient: 5-year-old child, raised as a boy. Chief Complaint: Respiratory distress. History: Born at home; posterior hypospadias repair at age 2 without karyotyping; early pubic hair development; family history of unexplained neonatal death. Examination: Hypertension (180/100 mmHg, >99th percentile). Ambiguous genitalia (Prader Sc
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