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Start free with Eleplan46,XY difference of sex development-adrenal insufficiency due to CYP11A1 deficiency
ORPHA:168558Disease
Also called 46,XY disorder of sex development-adrenal insufficiency due to CYP11A1 deficiency · XY sex reversal-adrenal failure
What it is
A rare, genetic, developmental defect during embryogenesis disorder characterized by severe, early-onset, salt-wasting adrenal insufficiency and ambiguous/female external genitalia (irrespective of chromosomal sex) due to mutations in the CYP11A1 gene. Milder cases may present delayed onset of adrenal gland dysfunction and genitalia phenotype may range from normal male to female in individuals with 46,XY karyotype. Imaging studies reveal hypoplastic/absent adrenal glands and biochemical findings include low serum cortisol, mineralocorticoids, androgens, and sodium, with elevated potassium levels.
Key facts
- Prevalence
- <1 / 1 000 000
- Age of onset
- Infancy, Neonatal
- Inheritance
- Autosomal dominant, Autosomal recessive
- Classified as
- Disease
Prevalence figures describe populations, not individuals, and are often estimates from a single study. Where the figure is an incidence or a birth prevalence, it says so.
Signs and symptoms
Very common80–99%
44- Abnormality of cholesterol metabolism
- Abnormality of prenatal development or birth
- Abnormality of the Leydig cells
- Abnormal sex determination
- Abnormal urine potassium concentration
- Absence of secondary sex characteristics
- Acidosis
- Adrenocorticotropic hormone excess
- Agenesis of corpus callosum
- Ambiguous genitalia, male
- Aplasia of the uterus
- Cryptorchidism
- Decreased circulating aldosterone level
- Decreased circulating androgen level
- Decreased circulating cortisol level
- Decreased fertility
- Decreased testicular size
- Dehydration
- Delayed puberty
- Delayed skeletal maturation
- Failure to thrive
- Feeding difficulties
- Female external genitalia in individual with 46,XY karyotype
- Generalized bronze hyperpigmentation
- Generalized hyperpigmentation
- Gynecomastia
- Hyperkalemia
- Hypernatriuria
- Hyponatremia
- Hypotension
- Hypovolemia
- Increased circulating ACTH level
- Increased circulating renin level
- Induced vaginal delivery
- Low maternal serum estriol
- Male pseudohermaphroditism
- Neonatal hypoglycemia
- Osteoporosis
- Primary adrenal insufficiency
- Reduced bone mineral density
- Renal salt wasting
- Sex reversal
- Urogenital sinus anomaly
- Vomiting
Common30–79%
4These ranges are how often a sign appears across everyone diagnosed, not a prediction for one person — most people have some of these and not others. Orphanet also records findings that are specifically absent in this disease; those are in the data but not listed here.
Gene
ICD-10 codes
ICD-10 has no distinct code for most rare diseases, so many are filed under the nearest available one. A shared code identifies the group, not this disease — the ORPHAcode above is what identifies it.
Cross-references
Orphadata Science: Free access data from Orphanet. © INSERM 1999. Data version 2026-06-23. Available under CC BY 4.0. This is a reference, not medical advice.
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