Black tongue due to adrenocortical insufficiency

摘要

A 15-year-old boy presented with an eight-year history of painless black patches of the tongue that had persisted despite repeated consultations with dermatologists. Physical examination revealed a generalised bronze appearance of the skin and bluish-black patches of the dorsal surface of the tongue. Laboratory tests revealed a plasma cortisol level of 3.1 meg/ dl (5-23), a corticotropin level of 5.530 pg/ml (5-46), and negative adrenal gland autoantibodies. These results were consistent with the diagnosis of primary adrenocortical insufficiency (Addison disease). Since adrenocortical insufficiency is frequently associated with X-linked adrenoleucodystrophy (X-ALD), proper investigations were addressed. Abnormal