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    Osler-Weber-Rendu syndrome

    Hereditary hemorrhagic telangiectasia; HHT

    Osler-Weber-Rendu syndrome is an inherited disorder of the blood vessels that can cause excessive bleeding.

    Causes

    Osler-Weber-Rendu syndrome is a condition passed down through families. It results from a problem in one ofseveral genes. Scientists have identified some of the genes involved. They do not know exactly how the gene defects lead to problems seen in persons with this syndrome, but it involves proper development of blood vessels.

    Symptoms

    People with Osler-Weber-Rendu syndrome can develop abnormal blood vessels called arteriovenous malformations (AVMs) in several areas of the body.

    If they are on the skin, they are called telangiectasias. The abnormal blood vessels can also develop in the brain, lungs, liver, intestines, or other areas.

    Symptoms of this syndrome include:

    • Frequent nosebleeds in children
    • GI bleeding, including loss of blood in the stool or dark black stools
    • Port wine stain
    • Seizures or unexplained, small strokes (from bleeding into the brain)
    • Shortness of breath

    Exams and Tests

    An experienced health care provider can detect telangiectases during a physical examination. There is often a family history of hereditary hemorrhagic telangiectasia.

    Signs include:

    • Abnormal blood vessels that bleed easily in the throat, bowels, or airways
    • AVM seen on chest x-ray
    • Decreased oxygen levels in the blood
    • Heart failure
    • Hepatomegaly
    • Iron deficiency anemia

    Tests include:

    • Blood gas tests
    • Blood tests
    • Echocardiogram
    • Endoscopy

    Genetic testingis available to look for changes in genes associated with this syndrome.

    Treatment

    Treatments may include:

    • Surgery to treat bleeding in some areas
    • Electrocautery or laser surgery to treat frequent or heavy nosebleeds
    • Endovascular embolization to treat abnormal blood vessels in the brain and other parts of the body

    Some patients respond to estrogen therapy, which can reduce bleeding episodes. Avoid taking blood-thinning medications. Iron may also be given if there is a lot of blood loss leading to anemia. Some drugs that affect blood vessel development are being studied as possible future treatments.

    Some patients may need to take antibiotics before having dental work or surgery. Ask your doctor what precautions you should take.

    Support Groups

    HHT Foundation International -- www.hht.org

    Outlook (Prognosis)

    People with this syndrome can live a completely normal lifespan, depending on the parts of the body where the AVMs are located.

    • Heart failure
    • High blood pressure in the lungs (pulmonary hypertension)
    • Internal bleeding
    • Shortness of breath

    When to Contact a Medical Professional

    Call your health care provider if you or your child has frequent nose bleeds or other signs of this disease.

    Prevention

    Genetic counseling is recommended for couples who want to have children and who have a family history of hereditary hemorrhagic telangiectasia. Medical treatments can prevent certain types of strokes and heart failure.

    References

    McDonald J, Bayrak-Toydemir P, Pyeritz RE. Hereditary hemorrhagic telangiectasia: an overview of diagnosis, management, and pathogenesis. Genet Med. 2011 Jul;13(7):607-16.

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            Review Date: 5/7/2013

            Reviewed By: Chad Haldeman-Englert, MD, FACMG, Wake Forest School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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