A Rare Cause of Chronic Diarrhea Diagnosed by Endoscopic Ultrasound–Guided Fine-Needle Aspiration

A 62-year-old man presented with a 3-month history of diarrhea (10–14 nonbloody stools/d), anorexia, and lethargy. Physical examination showed euvolemia and hyperpigmentation (Figure A) of buccal mucosa/lips, palmar creases, knuckles, and a scar on his back. His blood pressure was 110/76 mm Hg, with a postural decrease of 22/10 mm Hg. On evaluation, he had anemia (hemoglobin level, 9.6 g/dL) and hyponatremia (serum sodium level, 122 mmol/L). Serum and urine osmolality were 262 and 380 mOsmol/L, respectively, and urine spot sodium level was 46 mmol/L.

Source: Clinical Gastroenterology and Hepatology - August 7, 2015 Category: Gastroenterology Authors: Harpal S. Dhaliwal, Saroj K. Sinha, Rakesh Kochhar Tags: Electronic Image of the Month Source Type: research