A 26-year-old Sudanese woman was referred to the endocrinology clinic for investigation of low serum cortisol detected during investigations for fertility difficulties. There were no symptoms or signs to suggest adrenal insufficiency, nor did she have any overt Cushingoid features to suggest exogenous glucocorticoid exposure. Her blood pressure was 120/84 mmHg without postural drop. Although she had a generalised dark complexion, her face was a lighter shade compared with the rest of her body.
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