PMC5548677_01
The skin examination findings on admission. (A, B, C, D) Brown hyperpigmentation on the face (black arrows), lips (black arrow), and trunk.
1349-7235-56-1843-g001.jpg
PMC5548677_01_1349-7235-56-1843-g001.jpg
g001
A skin examination revealed brown freckles mainly on his face, lip, and trunk (Fig. 1).
Non-contrast abdominal computed tomography image. Enlargement of the bilateral adrenal glands without calcification was noted (white arrowheads).
1349-7235-56-1843-g002.jpg
PMC5548677_01_1349-7235-56-1843-g002.jpg
g002
Adrenal insufficiency was suspected on the basis of these clinical findings and laboratory data, and abdominal ultrasonography and non-contrast computed tomography (CT) were immediately performed to examine the patient's adrenal glands; these showed enlargement of the bilateral adrenal glands (Fig. 2).
Non-contrast chest computed tomography image. Numerous centrilobular nodules with at least one small cavity were observed in both apical lung fields.
1349-7235-56-1843-g003.jpg
PMC5548677_01_1349-7235-56-1843-g003.jpg
g003
Chest radiography and non-contrast chest CT revealed multiple nodular shadows with cavitation in the fields of both lungs (Fig. 3).
The skin examination findings after the treatment.
1349-7235-56-1843-g004.jpg
PMC5548677_01_1349-7235-56-1843-g004.jpg
g004
After the treatment, his hyperpigmentation was markedly ameliorated (Fig. 4), and he was discharged after one month of hospitalization.