Diffuse Hair Loss in Addison Disease: A Reason for X-Linked Adrenoleukodystrophy Screening

April 2012 in “ Journal of the American Academy of Dermatology ”

Beatriz Lecumberri, M. Girós, María Josep Coll, Amparo Marco, Mariano Casado, Luís Felipe Pallardo, Javier Pardo

diffuse hair loss Addison disease X-linked adrenoleukodystrophy ABCD1 gene corticosteroid therapy antadrenal cortex antibodies

TLDR Men with Addison disease should be screened for X-linked adrenoleukodystrophy if they have hair loss.

A 28-year-old man with Addison disease (AD) since age 14 experienced diffuse hair loss and neurological symptoms, leading to a diagnosis of X-linked adrenoleukodystrophy (ALD) due to a mutation in the ABCD1 gene. This case highlighted the importance of screening for ALD in adult men with AD, especially those without circulating antiadrenal cortex antibodies, as hair loss might be misattributed to AD or corticosteroid therapy, delaying correct diagnosis. The patient showed partial symptom relief with baclofen and lovastatin, and his condition remained stable over three years.

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