Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 2 2 2017 10 10 55 59 EN Mahboobe Hemmatabadi Department of Endocrinology and Metabolism, School of Medicine, Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Tina Deihim Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Neda Meftah Department of Endocrinology and Metabolism, School of Medicine, Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Sahar Karimpour Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2017 06 10 2017 08 27 Around 50% of patients with Addison disease (AD) have other autoimmune disorders. Neuropsychiatric symptoms may be presenting features of an Addisonian crisis or may be presented in patients with adrenoleukodystrophy (ALD) or Hashimoto encephalopathy; that these disorders are associated with primary adrenal insufficiency (AI). Nearly 5% of individuals with autoimmune AD develop pernicious anemia. X-linked ALD (X-ALD) is an inherited neurodegenerative disorder; a frequent but under-recognized cause of primary adrenocortical insufficiency. The classic picture of Vitamin B12 deficiency is subacute combined degeneration of the dorsal (posterior) and lateral spinal columns. The neuropathy is symmetrical, affects the legs more than the arms. It begins with paresthesia and ataxia and can progress to severe weakness, spasticity, paraplegia, even fecal, and urinary incontinence. We report a case of autoimmune AI who had presented with some neurologic symptoms. The challenging point was differentiating between X-ALD and other neurological syndromes that have an association with AI. We report a case of autoimmune adrenal insufficiency who had presented with some neurologic symptoms. The challenging point was differentiating between X-ALD and other neurological syndromes associating with adrenal insufficiency. https://crcp.tums.ac.ir/index.php/crcp/article/view/120 https://crcp.tums.ac.ir/index.php/crcp/article/download/120/78