In the simple virilizing form of CAH, the degree of virilization varies from simple clitoromegaly to the presence of a penile urethra.[6] Patients with simple virilizing CAH have 1% to 2% of 21-OH activity and, consequently, produce minimal aldosterone.[2] Serum renin and aldosterone levels were normal in this patient, preventing salt wasting and also delaying the diagnosis. The gene discussed is REN; the disease is congenital adrenal hyperplasia.