TY - JOUR T1 - All in a day’s work JF - British Journal of General Practice JO - Br J Gen Pract SP - 357 LP - 357 DO - 10.3399/bjgp14X680617 VL - 64 IS - 624 AU - Andrea Priestley Y1 - 2014/07/01 UR - http://bjgp.org/content/64/624/357.abstract N2 - Another duty doctor day and some blood tests have been received, faxed for urgent attention. They reveal hypothyroidism and renal dysfunction. Further enquiry into the notes introduces me to a 74-year-old Asian lady who had seen my colleague recently with general malaise and tiredness. The laboratory has run further tests and panhypopituitarism is suspected in view of a low random cortisol and low FSH. The books tell me that panhypopituitarism can present insidiously. Its prevalence and incidence are low and in a practice of 10 000 there may be just three or four patients with this condition.Clearly immediate action is needed so I call her at home. She does not answer the telephone so I decide to visit. It is 3.30pm … ER -