This is the report of a 28 year old woman who had a holocranial pulsating headache once a month with nausea, photophobia and phonophobia lasting about 48 hours. There was no preceding aura. The headache used to subside on every occasion with profuse epistaxis from both nostrils. Her neurological and otolaryngological examination was normal. MRI brain showed no abnormality. During one of the examinations at the time of the headache and epistaxis, she was found to have bilateral congestion of nasal mucosa with no obvious identifi cation of bleeding points. This case illustrates that migraine can result in epistaxis in some patients.

Recently, intravenous iron supplements has become increasingly popular because it allows administration of large quantity of iron dosage with simple infusion and is more effective in raising the hemoglobin levels and have less drug-related side effects as compared to oral iron supplementation. Multiple IV formulations of iron are available. However, there have been reports of transient asymptomatic hypophosphatemia with its use. We report here a patient with iron deficiency anemia secondary to menorrhagia, who presented with confusion, disorientation, muscle cramps and severe fatigue 3 weeks following intravenous ferric carboxymaltase from hypophosphatemia.