Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in Romania
Hereditary hemorrhagic telangiectasia (HHT) has significant morbidity due to multiorgan involvement and an unpredictable disease course. We analyzed the data of 14 patients diagnosed with HHT. The case series comprised 14 patients with a median age at presentation of 48 years old (41–74 years). In t...
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MDPI AG
2022-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/12/2959 |
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| author | Christopher Pavel Teodor Cabel Dragoș Dinuță Alexandru Zaharia Simona Olimpia Dima Vasile Sandru Mugur Cristian Grasu Mariana Mihaila |
| author_facet | Christopher Pavel Teodor Cabel Dragoș Dinuță Alexandru Zaharia Simona Olimpia Dima Vasile Sandru Mugur Cristian Grasu Mariana Mihaila |
| author_sort | Christopher Pavel |
| collection | DOAJ |
| description | Hereditary hemorrhagic telangiectasia (HHT) has significant morbidity due to multiorgan involvement and an unpredictable disease course. We analyzed the data of 14 patients diagnosed with HHT. The case series comprised 14 patients with a median age at presentation of 48 years old (41–74 years). In twelve patients (85.7%), the diagnosis was confirmed by using the Curacao Criteria. The most common reason for admission was epistaxis, with 9 patients (57%) presenting with nosebleed refractory to prolonged self-tamponade. The biochemical abnormalities identified were elevations in AP and gamma-GT; liver synthetic function was generally normal, even though 21% of patients had clinical or imaging findings for cirrhosis. Nosebleeds were the main reason for admission and significantly impacted quality of life through anemia and frequent hospital admissions. However, the visceral manifestations seemed to be more serious. The hepatic arteriovenous malformations (AVMs) appeared to remain asymptomatic or led to minimal changes for the majority of patients; some cases were associated with liver and biliary tract ischemia, necrosis leading to acute liver failure and even death. Hepatic AVMs can also lead to high-output heart failure due to arterio-venous shunting. The most frequent AVM was hepatic artery to hepatic vein, with secondary hepatic vein dilation and hemodynamic consequences. |
| first_indexed | 2024-03-09T17:08:10Z |
| format | Article |
| id | doaj.art-353106e111e1423b95d04647a8ebb009 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T17:08:10Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-353106e111e1423b95d04647a8ebb0092023-11-24T14:16:13ZengMDPI AGDiagnostics2075-44182022-11-011212295910.3390/diagnostics12122959Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in RomaniaChristopher Pavel0Teodor Cabel1Dragoș Dinuță2Alexandru Zaharia3Simona Olimpia Dima4Vasile Sandru5Mugur Cristian Grasu6Mariana Mihaila7Department of Gastroenterology, Emergency Clinical Hospital Bucharest, 014461 Bucharest, RomaniaDepartment of Gastroenterology, Emergency Clinical Hospital Bucharest, 014461 Bucharest, RomaniaDepartment of Internal Medicine, Fundeni Clinical Institute, 022328 Bucharest, RomaniaDepartment of Internal Medicine, Fundeni Clinical Institute, 022328 Bucharest, RomaniaDepartment of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, RomaniaDepartment of Gastroenterology, Emergency Clinical Hospital Bucharest, 014461 Bucharest, RomaniaDepartment of Interventional Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, RomaniaDepartment of Internal Medicine, Fundeni Clinical Institute, 022328 Bucharest, RomaniaHereditary hemorrhagic telangiectasia (HHT) has significant morbidity due to multiorgan involvement and an unpredictable disease course. We analyzed the data of 14 patients diagnosed with HHT. The case series comprised 14 patients with a median age at presentation of 48 years old (41–74 years). In twelve patients (85.7%), the diagnosis was confirmed by using the Curacao Criteria. The most common reason for admission was epistaxis, with 9 patients (57%) presenting with nosebleed refractory to prolonged self-tamponade. The biochemical abnormalities identified were elevations in AP and gamma-GT; liver synthetic function was generally normal, even though 21% of patients had clinical or imaging findings for cirrhosis. Nosebleeds were the main reason for admission and significantly impacted quality of life through anemia and frequent hospital admissions. However, the visceral manifestations seemed to be more serious. The hepatic arteriovenous malformations (AVMs) appeared to remain asymptomatic or led to minimal changes for the majority of patients; some cases were associated with liver and biliary tract ischemia, necrosis leading to acute liver failure and even death. Hepatic AVMs can also lead to high-output heart failure due to arterio-venous shunting. The most frequent AVM was hepatic artery to hepatic vein, with secondary hepatic vein dilation and hemodynamic consequences.https://www.mdpi.com/2075-4418/12/12/2959hereditary hemorrhagic telangiectasia—HHTarteriovenous malformations—AVMepistaxissecondary hepatic vein dilatation |
| spellingShingle | Christopher Pavel Teodor Cabel Dragoș Dinuță Alexandru Zaharia Simona Olimpia Dima Vasile Sandru Mugur Cristian Grasu Mariana Mihaila Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in Romania Diagnostics hereditary hemorrhagic telangiectasia—HHT arteriovenous malformations—AVM epistaxis secondary hepatic vein dilatation |
| title | Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in Romania |
| title_full | Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in Romania |
| title_fullStr | Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in Romania |
| title_full_unstemmed | Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in Romania |
| title_short | Hereditary Hemorrhagic Telangiectasia—A Case Series Experience from a Liver Transplant Center in Romania |
| title_sort | hereditary hemorrhagic telangiectasia a case series experience from a liver transplant center in romania |
| topic | hereditary hemorrhagic telangiectasia—HHT arteriovenous malformations—AVM epistaxis secondary hepatic vein dilatation |
| url | https://www.mdpi.com/2075-4418/12/12/2959 |
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