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- $Unique_ID{BRK03811}
- $Pretitle{}
- $Title{Hemorrhagic Telangiectasia, Hereditary}
- $Subject{Hemorrhagic Telangiectasia Hereditary Osler-Weber Rendu Syndrome
- Rendu-Osler-Weber Syndrome HHT von Willebrand Disease
- Calcinosis-Raynaud-Scleroderma-Telangiectasia Syndrome (CRST) Multiple
- Phlebectasias Spider Nevi Cherry Angiomas }
- $Volume{}
- $Log{}
-
- Copyright (C) 1986, 1988, 1989, National Organization for Rare Disorders, Inc.
-
- 285:
- Hemorrhagic Telangiectasia, Hereditary
-
- ** IMPORTANT **
- It is possible the main title of the article (Hereditary Hemorrahagic
- Telangiectasia) is not the name you expected. Please check the SYNONYMS
- listing to find the alternate names and disorder subdivisions covered by
- this article.
-
- Synonyms
-
- Osler-Weber Rendu Syndrome
- Rendu-Osler-Weber Syndrome
- HHT
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- von Willebrand Disease
- Calcinosis-Raynaud-Scleroderma-Telangiectasia Syndrome (CRST)
- Multiple Phlebectasias
- Spider Nevi
- Cherry Angiomas
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
-
- Hereditary Hemorrhagic Telangiectasia (HHT or Osler-Weber-Rendu Syndrome) is a
- hereditary disorder characterized by blood vessel lesions (telangiectases) on
- the skin, mucous membranes and in many internal organs. Often, patients
- exhibit signs of anemia caused by bleeding of the telangiectases.
-
- Symptoms
-
- Individuals with Hereditary Hemorrhagic Telangiectasia develop red-to-violet
- lesions usually in the nasal mucous membranes (mucosa) and on the skin. The
- cheeks, ears, lips, and tongue are chiefly affected. Lesions also occur in
- the gastrointestinal tract and secondarily in other organs including the
- lungs, brain, spinal cord and liver. Bleeding can occur spontaneously or as
- a result of injury. Bleeding from the nose (epistaxis) and gastrointestinal
- tract becomes more severe with age and may lead to chronic anemia. Vein
- abnormalities (arteriovenous fistulae) may lead to a bluish discoloration of
- the skin (cyanosis), an increase in the number of red blood cells
- (polycythemia), clubbed fingers, and sometimes, stroke. While mortality as a
- result of this disorder appears to be less than ten percent, Hereditary
- Hemorrhagic Telangiectasia can cause many complications especially since it
- is often misdiagnosed or undiagnosed. Individuals with the disease and their
- families should be closely monitored by as physician familiar with the
- disease.
-
- Causes
-
- Hereditary Hemorrhagic Telangiectasia is a hereditary disorder, transferred
- as an autosomal dominant trait. (Human traits including the classic genetic
- diseases, are the product of the interaction of two genes for that condition,
- one received from the father and one from the mother. In dominant disorders,
- a single copy of the disease gene (received from either the mother or father)
- will be expressed "dominating" the normal gene and resulting in appearance of
- the disease. The risk of transmitting the disorder from affected parent to
- offspring is 50% for each pregnancy regardless of the sex of the resulting
- child.) Symptoms of Hereditary Hemorrhagic Telangiectasia such as blood
- vessel lesions (telangiectases) in the lungs, brain, and liver, appear to be
- caused by abnormal connections between arteries and veins (arteriovenous
- fistulae). Telangiectases occur when the fistulae form to replace
- capillaries which normally connect small veins (venules) and small arteries
- (arterioles). The absence of intervening capillaries between the venules and
- arterioles are responsible for the profuse bleeding of the lesions.
-
- Affected Population
-
- Hereditary Hemorrhagic Telangiectasia can affect people of both sexes and all
- ages. The incidence in Europe has been reported to be 1 in 50,000. However,
- this might not be an accurate estimate in light of missed or improper
- diagnosis.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Hereditary
- Hemorrhagic Telangiectasia. Comparisons may be useful for a differential
- diagnosis:
-
- von Willebrand Disease is a hereditary blood clotting disorder
- characterized by prolonged bleeding. Blood clotting is slowed due to a
- deficiency of the von Willebrand factor protein and factor VIII protein (the
- factor VIII complex). Also, platelets do not stick normally, causing
- excessively slow clotting time. Increased risk of excessive bleeding
- following surgery, dental procedures or injury occurs in patients with this
- disorder. With proper treatment and appropriate precautions, few patients
- become seriously handicapped by von Willebrand Disease. (For more
- information on this disorder, choose "von Willebrand" as your search term in
- the Rare Disease Database.)
-
- Caldcinosis-Raynaud-Sclerodactyly-Telangiectasisa Syndrome (CRST) is a
- combination of various symptoms, sand is usually due to Scleroderma.
- Calcinosis is marked by deposits of calcium salts in focal nodules in various
- body tissues other than the connective tissue which supports the various
- organs (parenchymatous viscera). Raynaud's Phenomenon involves a spasm of
- the arteries in the fingers causing sensations of numbness and cold.
- Sclerodactyly (acrosclerosis) is a form of Scleroderma which occurs with
- Raynaud's Phenomenon. Telangiectasia is a discolored enlargement of blood
- vessels visible in the skin. (For more information, choose "Scleroderma" and
- "Raynaud" as your search terms in the Rare Disease Database.
-
- Multiple Phlebectasias refers to enlargement of veins.
-
- Spider Nevi are small abnormally enlarged arteries visible in the skin
- with radiating branches resembling the legs of a spider. These arteries
- appear to have a dull red color.
-
- Cherry Angiomas (senile hemangiomas) consists of a red papule due to the
- weakening of the capillary wall, seen in many people over thirty years of
- age. These spots are also known as DeMorgan's or ruby spots.
-
- Therapies: Standard
-
- Treatment of Hereditary Hemorrhagic Telangiectasia) has been mainly concerned
- with preventing or stopping bleeding of the telangiectatic lesions and the
- removal or blockage of exceptionally large lesions or arteriovenous fistulae.
-
- Cauterization, whether electrical or with laser light, of telangiectases
- in the nasal mucosa may be of temporary benefit since new lesions can grow.
-
- Surgical removal of arteriovenous fistulae has been used in the past, but
- more recently occlusion by balloon embolotherapy has been found effective in
- the treatment of pulmonary arteriovenous fistulae. Nosebleed (epistaxis) can
- sometimes be controlled by applying a compress saturated with
- vasoconstrictors such as phenylephrine to the ruptured lesion.
-
- Blood transfusions or iron replacement therapy, either orally or by
- transfusing iron dextran, have been used to combat anemia.
-
- Gastrointestinal lesions that produce severe hemorrhage may require
- surgical removal.
-
- Therapies: Investigational
-
- Estrogen and progesterone therapy have been used experimentally to prevent
- bleeding. Recent findings indicate that estrogen is not effective while
- progesterone may hold some promise.
-
- This disease entry is based upon medical information available through
- June 1988. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Hereditary Hemorrhagic Telangiectasia, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- HHT Foundation International Inc.
- P.O. Box 8087
- New Haven, CT 06530
-
- Dr. Robert I White, Jr.
- Yale School of Medicine
- Department of Diagnostic Radiology
- 333 Cedar Street
- P.O. Box 3333
- New Haven, CT 06510
-
- NIH/National Heart, Lung and Blood Institute
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-4236
-
- For information on genetics and genetic counseling referrals, please
- contact:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10605
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- MERCK MANUAL OF DIAGNOSIS AND THERAPY: Robert Berkow et al., eds.; American
- Medical Association, 1982. P. 1119.
-
-