Hyperpigmentation as a clue to Addison disease

Abstract

A 66-year-old woman presented to our department with generalized fatigue and loss of appetite. A review of her medical record showed that at age 52 she had undergone kidney transplant for end-stage kidney disease, receiving treatment of tacrolimus and mycophenolate after induction therapy with methylprednisolone 1,000 mg/day tapered over 3 months. After that, without steroids or antihypertensive drugs, her blood pressure had remained within the normal range. Mild hyperkalemia had been noted, and her fasting blood glucose was in the normal range.