Osler-Weber-Rendu disease or hereditary hemorrhagic telangiectasia. Case report

Authors

DOI:

https://doi.org/10.5281/zenodo.13123067

Keywords:

arteriovenous malformations, hereditary hemorrhagic telangiectasia, vascular diseases

Abstract

Introduction: hereditary hemorrhagic telangiectasia or Osler-Weber-Rendu disease is of genetic origin and is rare. Patients present anomalous communications between arterioles and venules, and specific malformations in internal organs. Its diagnosis is generally based on the clinical and radiological criteria of Curaçao.

Objetivo: describe the imaging findings leading to the diagnosis of hereditary hemorrhagic telangiectasia in a patient.

Case presentation: female patient, 67 years old, mixed race, with apparent health history. She went to a specialized consultation due to hemoptysis; During the anamnesis she did not report pain or other symptoms. On physical examination, ulcers were found at the base of the tongue, and nails that looked like watch glass. Complementary imaging tests were indicated. In them, a network of dilated and tortuous vessels, and another peripheral capillary, were observed. A spiculated nodular image was also seen, related to the vascular structure, and the appearance of small pulmonary telangiectasia.

Conclusion: the diagnostic suspicion of Osler-Weber-Rendu disease arose from the patient's symptoms and physical examination, in accordance with the Curaçao criteria. And it was corroborated by computerized axial angiotomography of the thorax and abdomen (simple and contrasted). These imaging examinations were decisive both in identifying the characteristic arteriovenous malformations and in accurately detailing the vascular lesions through volumetric reconstructions. This case shows the importance of imaging techniques in the diagnosis of patients suspected of suffering from hereditary hemorrhagic telangiectasia.

Downloads

Download data is not yet available.

Author Biographies

Nidhessy Pages Morales, Hospital Provincial Docente Clínico Quirúrgico “Manuel Ascunce Domenech”. Camagüey

Especialista de Primer Grado en Imagenología y Medicina General Integral. Profesor Instructor.

José Ramón Guerra Menéndez, Hospital Provincial Docente Clínico Quirúrgico “Manuel Ascunce Domenech”. Camagüey

Especialista de Primer y Segundo Grados en Imagenología. Especialista de Primer Grado en Medicina General Integral. Profesor Auxiliar.

Elizabeth Ramírez Reyes, Hospital Provincial Docente Clínico Quirúrgico “Manuel Ascunce Domenech”. Camagüey

Especialista de Primer Grado en Imagenología y Medicina General Integral.

References

Ortega-Torres A, Sánchez-Díaz G, Villaverde-Hueso A, Posada-De la Paz M, Alonso-Ferreira V. Mortalidad atribuida a telangiectasia hemorrágica hereditaria y variabilidad geográfica en España (1981-2016). Gac Sanit [Internet]. Feb 2020 [citado 27 Oct 2023];34(1):37-43. Disponible en: https://scielo.isciii.es/pdf/gs/v34n1/0213-9111-gs-34-01-37.pdf

Álvarez M, Otárola M, Novoa TO, Moyano D, Cabezas L. Telangiectasia hemorrágica hereditaria: a propósito de un caso clínico. Rev. Otorrinolaringol. Cir. Cabeza Cuello [Internet]. Mar 2018 [citado 27 Oct 2023];78(1):65-70. Disponible en: https://www.scielo.cl/pdf/orl/v78n1/0718-4816-orl-78-01-0065.pdf

Henao-Estrada RF, Jaramillo-Bedoya D, Castro-Sánchez S, Vizcaíno-Carruyo J, Restrepo-Gutiérrez JC. Síndrome de Osler-Weber-Rendu: presentación de un caso clínico y revisión de la literatura. Hepatología [Internet]. 2020 [citado 27 Oct 2023];1(2):176-85. Disponible en: https://revistahepatologia.org/index.php/hepa/article/download/25/21/22

Kritharis A, Al-Samkari H, Kuter DJ. Hereditary hemorrhagic telangiectasia: diagnosis and management from the hematologist’s perspective. Haematologica [Internet]. Sep 2018 [citado 27 Oct 2023];103(9):1433-43. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119150/pdf/1031433.pdf

Kühnel T, Wirsching K, Wohlgemuth W, Chavan A, Evert K, Vielsmeier V. Hereditary hemorrhagic telangiectasia. Otolaryngol Clin North Am. Feb 2018;51(1):237-54.

Mosquera-Klinger GA, Gálvez-Cárdenas K, Valencia-Ruíz AM. Diagnóstico y tratamiento de pacientes con telangiectasia hemorrágica hereditaria (síndrome de Rendu-Osler-Weber) en un hospital universitario en Colombia. Rev Col Gastroenterol [Internet]. Jun 2019 [citado 29 Oct 2023];34(2):152-8. Disponible en: http://www.scielo.org.co/pdf/rcg/v34n2/0120-9957-rcg-34-02-00152.pdf

Robert F, Desroches-Castan A, Bailly S, Dupuis-Girod S, Feige JJ. Future treatments for hereditary hemorrhagic telangiectasia. Orphanet J Rare Dis [Internet]. 2020 [citado 29 Oct 2023];15(1):4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6945546/pdf/13023_2019_Article_1281.pdf

Karlsson T, Cherif H. Mutations in the ENG, ACVRL1, and SMAD4 genes and clinical manifestations of hereditary haemorrhagic telangiectasia: experience from the Center for Osler’s Disease, Uppsala University Hospital. Ups J Med Sci [Internet]. Sep 2018 [citado 28 Oct 2023];123(3):153-7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198721/pdf/iups-123-1483452.pdf

Droege F, Thangavelu K, Stuck BA, Stang A, Lang S, Geisthoff U. Life expectancy and comorbidities in patients with hereditary hemorrhagic telangiectasia. Vasc Med [Internet]. Ago 2018 [citado 27 Oct 2023];23(4):377-83. Disponible en: https://journals.sagepub.com/doi/pdf/10.1177/1358863X18767761?download=true

Jackson SB, Villano NP, Benhammou JN, Lewis M, Pisegna JR, Padua D. Gastrointestinal manifestations of hereditary hemorrhagic telangiectasia (HHT): a systematic review of the literature. Dig Dis Sci [Internet]. Oct 2017 [citado 28 Oct 2023];62(10):2623-30. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641264/pdf/nihms907638.pdf

Gossage JR, Mandel J. Pulmonary arteriovenous malformations: epidemiology, etiology, and pathology in adults. En: UpToDate, Post TW (Ed) [Internet]. Waltham: UpToDate; 2019 (citado 27 Oct 223)]. Disponible en: http://uptodate.dratef.net/contents/UTD.htm?27/0/27656/abstract/1

Riera-Mestre A, Ribas J, Castellote J. Tratamiento de la telangiectasia hemorrágica hereditaria en el paciente adulto. Med Clin. 2019;152(7):274-80.

Tortora A, Riccioni ME, Gaetani E, Ojetti V, Holleran G, Gasbarrini A. Rendu-Osler-Weber disease: a gastroenterologist’s perspective. Orphanet J Rare Dis [Internet]. Jun 2019 [citado29 Oct 2023];14(1):130. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6555961/pdf/13023_2019_Article_1107.pdf

Published

2024-07-30

How to Cite

1.
Pages Morales N, Guerra Menéndez JR, Ramírez Reyes E. Osler-Weber-Rendu disease or hereditary hemorrhagic telangiectasia. Case report. Mediciego [Internet]. 2024 Jul. 30 [cited 2024 Oct. 16];30:e3783. Available from: https://revmediciego.sld.cu/index.php/mediciego/article/view/3783

Issue

Section

Case Report

Most read articles by the same author(s)