POMC and Adrenal insufficiency: The patient also exhibited progressive skin darkening over time (face, oral cavity mucous membrane and the tongue), hyperkalemia, with a serum potassium level of 6.5 mmol/L, elevated adrenocorticotropic hormone (ACTH) levels (44.4 pg/mL) and low cortisol levels (5 μg/dL), confirming adrenal insufficiency.