Intended for healthcare professionals

Fillers A memorable patient

Unforeseen consequences

BMJ 1999; 319 doi: (Published 04 December 1999) Cite this as: BMJ 1999;319:1471
  1. Garrett Igoe, general practitioner
  1. Virginia, County Cavan, Republic of Ireland.

    It was not long after I had arrived to take over a singlehanded practice in a rural part of Ireland that I first met Jean. I was struck by her big hands, jutting chin, and rather waxy facial features. The fact that she had hypertension and diabetes lent support tomy clinical impression of acromegaly and that this had gone unnoticed in over three yearsof attendance at the hospital medical outpatient department added to the glow of satisfaction when the diagnosis was confirmed by an endocrinologist.

    Jean was glad to have a diagnosis but was nervous of the prospect of surgery when a computed tomogram showed the pituitary tumour …

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