What Is Your Diagnosis? Argyria

A 66-year-old woman presented to the emergency department with chest pain and dyspnea. Her skin was gray in color, particularly on the face and arms. The patient had a history of atrial fibrillation, but because of her aversion to Western medicine, she had not seen a physician in more than a year and had discontinued all medications, except for herbal and dietary supplements. She was taking more than 50 supplements daily including multiple vitamins, large quantities of carrot juice, N-acetylcysteine, and algae. She reported 1 year of intolerable abdominal pain that occurred 1 to 2 years prior to presentation, which she attempted to treat by consuming 1 qt of colloidal silver water daily; the abdominal pain had resolved by the time she presented to us and she had not consumed the colloidal silver water for at least 1 year prior to presentation. An electrocardiogram confirmed atrial fibrillation contributing to her presenting symptoms, which dissipated once appropriate medication was initiated.