Dados do Trabalho
CHILDHOOD DIAGNOSIS OF OSLER-WEBER-RENDU SYNDROME
Apresentação do caso
A eleven-year-old boy, from Ceará (Brazil), born from non-consanguineous parents. First symptoms started at eight months old, with multiple episodes of epistaxis and multiple hospitalizations due to respiratory distress. At age seven, he sought medical care due to low hearing and low oxygen saturation. During initial investigation in the emergency room, an echocardiogram was performed compatible with pulmonary fistulas. Family history was positive on the patient’s father side (his father and paternal uncles) for epistaxis since childhood without other complications. On examination, several telangiectasias were seen on his face, back and limbs, as well as a flat hemangioma in the region of the lumbar spine with no changes on neurological examination. An Angiography of the brain was performed which showed a vascular pattern on the surface of the left inferior parietal lobe. After carrying out a genetic investigation with whole exome sequencing it was identified a heterozygous mutation NM_0001183.C1121_1122DELINSgc p( Lys374Ser), leading to the diagnosis of Hereditary hemorrhagic telangiectasia. On follow up imaging, the patient presented a new entanglement of vessels in the upper region of the left caudate nucleus.
Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is an autosomal dominant disorder that causes abnormal blood vessel formation. The patients may have telangiectasias and arteriovenous malformations in various organs and can suffer from many complications including bleeding, anemia and high-output heart failure. Families with the same mutation exhibit considerable phenotypic variation, which is probably what happens in our patient’s the paternal side of the family.
Our case adds to the medical literature one more case of a rare disease with probable milder phenotypes in the paternal family.
Referências (se houver)
Osler-Weber-Rendu syndrome, epistaxis, hereditary hemorrhagic telangiectasia
Fonte de Fomento (se houver)
Declaração de conflito de interesses de TODOS os autores
The authors have no conflicts of interest.
Doenças cerebrovasculares e terapia intensiva em neurologia infantil
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP - São Paulo - Brasil
Cristiani Rocha Lima Cruz, Mariana Piva da Costa, Yan Victor Araujo Rodrigues, Leandro Alves Mendes, Andreia Braga Mota Azzoni, Larissa Baccoli de Souza, Flora Cruz de Almeida Ximenes, Daniel Shoji Hayashi, Ronan José Vieira Neto