Case A 63-year-old woman presented with increasing darkening of the skin, dizziness, and easy fatigability, nausea with occasional vomiting and progressive weight loss over eight months prior to presentation. There were no headaches, blurred vision, and neither loss of consciousness nor change in her bowel habit.
The medical history and systemic review revealed no abnormality and were not significant. Lab revelations Laboratory variable Serum level Na+ 136 mmo/L Cl- 100 mmo/L K+ 3.4 mmo/L HCO3 - 22 mmo/L Urea 2.8 mmo/L Creatinine 17.7 Umol/L Corticotrophin 550 pg per milliliter (upper limit of normal: 100 pg per milliliter) Total bilirubin 8.7 Umol/L Conjugated bilirubin 8.5 Umol/L AST 7iu/L ALT 8 iu/L Total protein 7.8g/L Albumin 3.4g/L Fasting blood sugar 5.6 mmo/L Packed cell volume 30% White blood count 5,800/mm3 Neutrophil 33 Lymphocyte 61 Eosinophil 6 Platelets Adequate and Normal…
