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- W2003191907 abstract "Sir, Sarah is obviously a depressed patient despite having four delightful children. However, apart from four teardrops, she appears to be losing 3 tufts of black hair. Furthermore, she appears to have a nodular goitre in the neck. As though this was not enough of a complication to the management of her diabetes, the bulging midriff raises the possibility of a well‒advanced pregnancy. This could account for the poor glycaemic control. It would be appropriate to include in her antenatal blood screen, an assessment of thyroid function including T3 and a screen for auto‒immune anti‒bodies. The blood picture may be a little complicated as apart from the tendency to macro‒cytosis with thyroid deficiency, a rapid succession of pregnancies may have depleted iron reserves. Both the pen picture and the illustration of this imaginary case provide a challenge for the clinician. I would hope that my reply to the GP would include results confirming my clinical suspicions, so that Sarah's diabetes would once more be under better control. DR ERIC BLAY*, * Hill Head, Hampshire" @default.
- W2003191907 created "2016-06-24" @default.
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- W2003191907 date "2000-01-01" @default.
- W2003191907 modified "2023-10-04" @default.
- W2003191907 title "Sarah: the picture tells a story?.." @default.
- W2003191907 doi "https://doi.org/10.1002/1528-252x(200010)17:7<235::aid-pdi117>3.0.co;2-z" @default.
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