Tongue Discoloration

A 33 year old woman with celiac disease presented with painless tongue discoloration lasting 3 weeks. Examination revealed hyperpigmented reticular patches on the dorsolateral tongue, sparing other mucosa. Laboratory tests indicated adrenal insufficiency, with elevated corticotropin levels and positive 21 hydroxylase antibodies, confirming autoimmune adrenal insufficiency (Addison’s disease). Treatment with oral hydrocortisone resolved the tongue hyperpigmentation within 4–8 weeks. This case highlights an uncommon presentation of isolated tongue discoloration as a sign of primary adrenal insufficiency.

A 33 year old woman with celiac disease presented with painless tongue discoloration lasting 3 weeks. Examination revealed hyperpigmented reticular patches on the dorsolateral tongue, sparing other mucosa. Laboratory tests indicated adrenal insufficiency, with elevated corticotropin levels and positive 21 hydroxylase antibodies, confirming autoimmune adrenal insufficiency (Addison’s disease). Treatment with oral hydrocortisone resolved the tongue hyperpigmentation within 4–8 weeks. This case highlights an uncommon presentation of isolated tongue discoloration as a sign of primary adrenal insufficiency.