A picture paints a thousand words.

A 56 year old woman was referred by her general practitioner with ongoing malaise. She had a history of recurrent epistaxis. On examination, there was extensive mucocutaneous telangiectasia (Figure 1). Her father and brother have a history of epistaxis and facial telangiectasia. Her presenting haemoglobin was 6.6 g/dl (normal, 13.0-18.0 g/dl), microcytic picture and ferritin of 3 ng/ml (normal, 22-274 ng/ml). She was transfused with packed red cells.