Table 2 Symptoms that may be regarded as secondary in nature, with an explanation as to how these symptoms may be seen as complications of Darwin’s primary disorder
Secondary symptomInterpretation
Recurrent boilsRecognized complication of atopic dermatitis
HematemesisComplication of forceful vomiting
Dental cariesComplication of recurrent vomiting
Skin pigmentationAddisonian pigmentation, due to increased ACTH/MSH secretion following excessive salt and fluid loss with repeated vomiting (Hayman 2011)
  • ACTH, adrenocorticotrophic hormone; MSH, melanocyte-stimulating hormone. The two hormones are released together from the pituitary, molecule for molecule, by splitting of a large parent molecule.