A 52-year-old man presented to the Emergency department because of 1-week history of nausea and abdominal pain. The patient referred generalized muscle pain, fatigue, hyporexia and 13kg weight loss since 18months ago. He also noticed a brown-colored pigmentation in his skin during the last year. Laboratory data showed an elevated white blood cell count (11,300/μL, 7900 neutrophils), hemoglobin 14.5mg/dL, potassium 5.37mmol/L, sodium 135.7mmol/L, magnesium 2.71mg/dL, phosphorus 4.7mg/dL, calcium 9.4mg/dL, glucose 70mg/dL, BUN 21mg/dL, VIH negative.