15 years old male child with genralized hyperpigmentation and recurrent oral thrush since 3 years of age .
No other signs and symptoms related to ADDISONs disease or hypoparathyroidism.
BP is normal .no postural drop . No significant hx of exposure to heavy metals . All other siblings are normal .
O/E :
Genralized punctate hyperpigmentation
Whitish lesions ( e surrounding erythema on the tongue ).
Systemic /Exam is normal .
ELECTROLYTES and RBS are normal .
CBC shows:
TLC count of 3000 e the ANC of 1260
Hb 10.1
Platelers 262k
S CALCIUM , TFTS , PTH are awaited.
S cortisol level yet not sent .
Differential diagnoses??