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Woman with a Blackened Tongue: A Case Report

Kyrillos Girgis, DO*, Cory Toomasian, MD* and Timothy Young, MD*

*Loma Linda University, Department of Emergency Medicine, Loma Linda, CA

Correspondence should be addressed to Kyrillos Girgis, DO at kgirgis@llu.edu

DOI: https://doi.org/10.5070/M5.52329 Issue 11:2
Visual EMCurrent IssueEndocrine
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Blackened Tongue. Photo. JETem 2026

ABSTRACT:

Primary adrenal insufficiency is a rare disease characterized by deficient production of glucocorticoids with or without a deficiency of mineralocorticoids and adrenal androgens.1 This disease can present as a range of symptoms provoking a visit to the emergency department (ED). In this case, we present a 40-year-old female who reported tongue and gingival discoloration, unintentional weight loss, and skin hyperpigmentation. The patient was evaluated by an endocrinologist in the ED, received a dose of steroids in the ED, and discharged home with a prescription for steroids. This case report illustrates the distinctive tongue discoloration seen in primary adrenal insufficiency, highlighting the need for early recognition in the emergency setting to enable prompt and appropriate management.

Topics: Endocrine, Addison’s disease, primary adrenal insufficiency, black tongue, steroids, skin hyperpigmentation.

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