2015 Volume 144 Pages 24-25
Hereditary hemorrhagic telangiectasia (HHT) is an uncommon disease characterized by the presence of abnormal telangiectasia and arteriovenous malformations that cause recurrent episodes of epistaxis. In case of recurrent epistaxis, the management of bleeding could be difficult in HHT patients. Systemic complication, such as arteriovenous shunt in lung and liver, can also occur in the clinical course. Once a systemic complication occurs, epistaxis can be severe and uncontrollable.
We experienced a female patient with HHT which was complicated with infective endocarditis. Though several hemorrhages were treated with argon plasma coagulation (APC), her epistaxis did not improve. After an aortic valve replacement was performed for infective endocarditis, the incidence of recurrent bleeding was reduced. It was considered that heart failure due to infective endocarditis caused the intractable nose bleeding. These clinical findings suggested that the management of systemic complications are most probably important for the control of recurrent epistaxis in HHT patients.
