Hereditary haemorrhagic telangiectasia
Extensions

  • Look into mouth with pen torch inspecting tongue and palate
  • Examine chest for bruits
  • Cardiovascular examination for high output cardiac failure
Questions

  • Anybody else in the family had similar problem?
  • GI bleeding
  • Epistaxis
  • Headaches, stroke (cerebral AV malformation)
Notes

  • Complications: Epistaxis, GI haemorrhage, iron deficiency anaemia, haempoptysis, subarachnoid, high output cardiac failure (due to hepatic artery-vein shunt)
  • Genes: endoglin-β, activin receptor-like kinaes 1 (ALK-1). Both expressed on vascular endothelial cells and implicated in signalling to members of TGF-beta family.