, Volume 57, Issue 6, pp 1465-1468
Date: 17 Nov 2011

Abdominal Mass, Anemia, Diabetes Mellitus, and Necrolytic Migratory Erythema

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Case Presentation and Evolution

A 47-year-old Hispanic man presented to an outside hospital in March 2011 for evaluation of nausea, vomiting, fatigue, intermittent diarrhea, and weight-loss.

He had suffered from alternating diarrhea and constipation for several months, associated with nausea and vomiting, as well as unintentional weight-loss of approximately 11 kg (25 lb) over a 2-year period. He had also noted the development of a new pruritic diffuse erythematous rash present on his back, chest, abdomen, and bilateral lower extremities. Interestingly, he also described recent difficulties in controlling his blood sugars, with glucose levels persistently ranging above 250 mg/dL. Additionally, there was a remote history of fatigue dating back approximately 3 years, associated with the progressive weight-loss.

His past medical history included alcoholism, with a drinking history of a six-pack of beer daily for many years, as well as depression and dermatitis. Upon cessation of drinking, th ...