title: Difficult venepuncture--it was all in the head!
abstract: OBJECTIVE
  To emphasise the importance of careful observations and demonstrate that significant conditions may, on occasion, be detected during blood donation.
  
  
  BACKGROUND
  Venepunctures, the bread and butter of blood donor services, can be difficult procedures. We describe an unusual presentation of a relatively rare disease detected during routine blood donations because of difficult venepunctures.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A growth hormone-secreting pituitary adenoma was diagnosed, and successfully treated, following the initial observation of hard-to-puncture skin during blood donations.
  
  
  CONCLUSIONS
  Seemingly trivial abnormalities may prove clinically important. One presentation of acromegaly is hard-to-puncture skin.
authors.affiliation: New Zealand Blood Service, Christchurch, New Zealand. krishna.badami@nzblood.co.nz
authors.forename: K G
authors.initials: KG
authors.lastname: Badami
authors.forename: I
authors.initials: I
authors.lastname: Chalmers
authors.forename: S
authors.initials: S
authors.lastname: Soule
authors.forename: D
authors.initials: D
authors.lastname: Walkden
mesh_terms: D000172:Acromegaly / Q000175:diagnosis* / Q000628:therapy; D000236:Adenoma / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D001782:Blood Donors; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D018962:Phlebotomy; D012867:Skin