Differential Diagnosis for Metabolic Disorders with Psychosis in Pediatric Population
Single Most Likely Diagnosis
- Diabetic Ketoacidosis (DKA): A common complication of diabetes in children, DKA can be triggered by surgical stress, leading to psychosis due to severe metabolic derangements, including hyperglycemia, acidosis, and electrolyte imbalances.
Other Likely Diagnoses
- Thyroid Storm: Although less common, thyroid storm can be precipitated by surgical stress in pediatric patients with untreated or undertreated hyperthyroidism, leading to psychosis, among other symptoms.
- Adrenal Insufficiency: Surgical stress can precipitate an adrenal crisis in children with adrenal insufficiency, resulting in psychosis, hypotension, and electrolyte disturbances.
- Pheochromocytoma: This rare tumor can cause episodic hypertension, tachycardia, and psychosis, especially during surgical stress, due to excessive catecholamine release.
Do Not Miss Diagnoses
- Congenital Adrenal Hyperplasia (CAH): A genetic disorder affecting adrenal steroid production, CAH can lead to adrenal crisis and psychosis during surgical stress if not properly managed.
- Methylmalonic Acidemia: A rare genetic disorder of amino acid metabolism, methylmalonic acidemia can cause severe metabolic acidosis, psychosis, and other complications during surgical stress.
- Propionic Acidemia: Another genetic disorder of amino acid metabolism, propionic acidemia can lead to severe metabolic acidosis, psychosis, and other life-threatening complications during surgical stress.
Rare Diagnoses
- Maple Syrup Urine Disease (MSUD): A rare genetic disorder of branched-chain amino acid metabolism, MSUD can cause severe metabolic acidosis, psychosis, and other complications during surgical stress.
- Urea Cycle Disorders: A group of rare genetic disorders affecting ammonia metabolism, urea cycle disorders can lead to severe hyperammonemia, psychosis, and other life-threatening complications during surgical stress.
- Organic Acidemias: A group of rare genetic disorders of organic acid metabolism, organic acidemias can cause severe metabolic acidosis, psychosis, and other complications during surgical stress.