Published: 8 January 2018
Author(s): Francisco Galeano-Valle, Lucía Higuera-Cabañes
Issue: January 2018
Section: Internal Medicine Flashcard

A 43-year-old woman with a 1-year history of 6-kg weight loss and weakness was diagnosed with primary hypothyroidism and started levothyroxine one week before. She presented to the emergency department with a 4-day history of abdominal pain and vomiting. Physical examination revealed BP 80/35mmHg, HR 110bpm, afebrile, slim build and generalized cutaneous hyperpigmentation, especially in the knuckles, the palmar and plantar creases (Fig. 1) and involving gingival mucosa and mucosal surface of lower lip (Fig.


Stay informed on our latest news!


This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.