Differential Diagnosis for High DHEA Levels

Single Most Likely Diagnosis

• Adrenal Hyperandrogenism: This condition is characterized by an overproduction of androgens, including DHEA, by the adrenal glands. It is a common cause of elevated DHEA levels and can lead to symptoms such as hirsutism, acne, and male pattern baldness in females.

Other Likely Diagnoses

• Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder that can cause an imbalance in androgen levels, including DHEA. It is often associated with insulin resistance, obesity, and irregular menstrual cycles.
• Congenital Adrenal Hyperplasia (CAH): CAH is a group of genetic disorders that affect the adrenal glands, leading to an overproduction of androgens, including DHEA. It can cause a range of symptoms, from mild to severe, and may require lifelong treatment.
• Adrenal Tumors: Benign or malignant tumors of the adrenal gland can produce excess DHEA, leading to elevated levels.

Do Not Miss Diagnoses

• Cushing's Syndrome: Although less common, Cushing's syndrome, caused by excess cortisol production, can also lead to elevated DHEA levels. Missing this diagnosis can have severe consequences, including hypertension, diabetes, and osteoporosis.
• Adrenal Carcinoma: A rare but aggressive form of cancer that can produce high levels of DHEA. Early detection is crucial for treatment and survival.

Rare Diagnoses

• Familial Hyperandrogenism: A rare genetic disorder that affects the production of androgens, including DHEA.
• DHEA-Producing Tumors of the Ovary: Rare ovarian tumors that can produce excess DHEA, leading to elevated levels.
• Hyperandrogenism due to Other Rare Genetic Disorders: Certain genetic disorders, such as hyperandrogenism-insulin resistance-acanthosis nigricans (HAIR-AN) syndrome, can also cause elevated DHEA levels.