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Visual Diagnosis in Emergency Medicine| Volume 57, ISSUE 4, e119-e121, October 2019

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Buccal Mucosa Hyperpigmentation as a Differential Diagnosis in a Patient With Undifferentiated Shock

  • Jorge Rafael Violante-Cumpa
    Correspondence
    Reprint Address: Jorge Rafael Violante-Cumpa, md, Internal Medicine Department, Hospital Universitario, Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Madero and Gonzalitos Avenue, N/N Col. Mitras Centro Monterrey, Nuevo León 64460, Mexico
    Affiliations
    Internal Medicine Department, Hospital Universitario, Dr. José Eleuterio González, Universidad Autónoma de Nuevo León Monterrey, Nuevo León, Mexico
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  • Luis Alberto Pérez-Arredondo
    Affiliations
    Internal Medicine Department, Hospital Universitario, Dr. José Eleuterio González, Universidad Autónoma de Nuevo León Monterrey, Nuevo León, Mexico
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  • Mario Alberto Treviño-Castro
    Affiliations
    Internal Medicine Department, Hospital Universitario, Dr. José Eleuterio González, Universidad Autónoma de Nuevo León Monterrey, Nuevo León, Mexico
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Published:September 03, 2019DOI:https://doi.org/10.1016/j.jemermed.2019.06.035
      Adrenal crisis (AC) remains an important cause of mortality in patients with adrenal insufficiency (AI). These crises are difficult to diagnose due to the insidious and nonspecific clinical course of the disease. Here, we present the case of a 41-year-old woman with altered mental status with an episode of AC. The case reveals the importance of a complete clinical examination to reach the diagnosis.
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      References

        • Bensing S.
        • Hulting A.
        • Husebye E.S.
        • Kämpe O.
        Epidemiology, quality of life and complications of primary adrenal insufficiency: a review.
        Eur J Endocrinol. 2016; 175: 107-116
        • Puar T.H.K.
        • Uk M.
        • Stikkelbroeck N.M.M.L.
        • Smans L.C.C.J.
        Adrenal crisis: still a deadly event in the 21st century.
        Am J Med. 2016; 129 (e1–e9): 339
        • Bancos I.
        • Hahner S.
        • Tomlinson J.
        • Arlt W.
        Diagnosis and management of adrenal insufficiency.
        Lancet Diabetes Endocrinol. 2014; 8587: 1-11
        • Brandão-neto R.A.
        • Freire de Carvalho J.
        Diagnosis and classification of Addison’s disease (autoimmune adrenalitis).
        Autoimmun Rev. 2014; 13: 408-411
        • Tucci V.
        • Sokari T.
        The clinical manifestations, diagnosis, and treatment of adrenal emergencies.
        Emerg Med Clin North Am. 2014; 32: 465-484
        • Alawi F.
        Pigmented lesions of the oral cavity: an update.
        Dent Clin North Am. 2013; 57: 699-710
        • Bornstein S.R.
        • Allolio B.
        • Arlt W.
        • et al.
        Diagnosis and treatment of primary adrenal insufficiency: an Endocrine Society Clinical Practice Guideline.
        J Clin Endocrinol Metab. 2016; 101: 364-389