Abstract
In March 2010, a 32-year-old woman presented to hospital following 4 days of profuse watery diarrhoea. Her medical history included mild asthma, hypertension, ischaemic heart disease (myocardial infarction treated with balloon angioplasty 11 years previously) and she was a cigarette smoker of 20 per day for 18 years. Regular medications comprised ramipril, doxazosin and salbutamol inhalers prn. On admission, she was apyrexic, tachycardic (124 bpm), hypertensive (blood pressure 152/82 mmHg) and was noted to be morbidly obese (body mass index: 41 kg/m2). Clinical examination revealed no abnormality. Urinalysis was unremarkable. Initial laboratory investigations showed: Hb 13.7 g/dl [normal range (NR) 11.5–16.5 g/dl], leucocyte count 11.0 × 109/l (NR 4.0–10.0 …
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