Pediatric Adrenal Insufficiency (Addison Disease) Differential Diagnoses

Updated: Jan 12, 2022
  • Author: Kimberly Tafuri, DO; Chief Editor: Sasigarn A Bowden, MD, FAAP  more...
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Diagnostic Considerations

Adrenal insufficiency (Addison disease) may be difficult to differentiate from other conditions (eg, chronic fatigue syndrome, depression) if its onset is gradual. [42, 43]

Physicians must consider adrenal insufficiency in the differential diagnosis of patients with suggestive symptoms, such as chronic fatigue, anorexia, nausea, vomiting, diarrhea, unexplained weight loss, dehydration, hypoglycemia, and hypotension. Clinicians caring for patients with other known autoimmune disorders should be attuned to this potential diagnosis. Other conditions that should be considered include adrenocorticotropic hormone (ACTH) receptor defect, adrenoleukodystrophy and adrenomyeloneuropathy, autoimmune polyglandular endocrinopathy syndromes, infectious adrenalitis (eg, in association with human immunodeficiency [HIV] infection or tuberculosis [TB]), adrenal hemorrhage, lipoid adrenal hyperplasia, and Wolman disease.

Antiphospholipid syndrome occasionally results in acute adrenal insufficiency secondary to bilateral adrenal hemorrhage. [15]

Differential Diagnoses