Half-and-half nails in a patient with Graves’ Disease

A 48-year-old Venezuelan woman, a manicurist, with no diagnosed illnesses, was brought to the emergency room because of acute disorientation. On admission, she was tachycardic, hypotensive, febrile, and dehydrated. Supraventricular tachycardia with narrow QRS and regular RR, leukocytosis with neutrophilia, and acute kidney injury (BUN 53.89 mg/dL reference value [8-23 mg/dL], serum creatinine 1.78 mg/dL [0.51-0.95 mg/dL]) were documented at admission. She was managed with amiodarone, adenosine, and electrical cardioversion before being transferred to the intensive care unit (ICU).