A 28-year-old previously healthy man presented to the emergency department after an episode of syncope. He also complained of vomiting and diffuse abdominal pain for the past 1day and sore throat for 3days. The patient also mentioned occasional vomiting, subjective weight loss, postural dizziness, and salt craving for last 6months. Vital signs were temperature of 100.5°F, blood pressure (BP) of 75/48mm of Hg, pulse rate of 122/min, regular, weight 55kg. Physical examination revealed a lethargic man with hyperpigmentation over lips (Fig. 1) and axilla, abdominal tenderness.
