[Clinical Picture] Crisis? What crisis? Abdominal pain and darkening skin in Addison's disease

A 19-year-old man presented with a 4-day history of abdominal pain, nausea, vomiting, and fever. He had no medical history. On examination his temperature was 38·8°C, he was dehydrated and tachycardic, and he had postural hypotension: his blood pressure was 110/40 mm Hg supine and 88/36 mm Hg standing. On palpation of his abdomen, the patient reported widespread pain with equivocal rebound tenderness. We also noted diffuse darkening of the mucous membranes and skin, which the patient said had gradually increased over the past 7 years.

from The Lancet https://ift.tt/3iCnxnq
via IFTTT