Case Report : Osler-Weber-Rendu Disease Uncovered by Preecla
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Hereditary Rendu-Osler disease (MRO) or hereditary hemorrhagic telangiectasia is a form of vascular dysplasia involving hemorrhagic symptoms, cutaneous mucosal telangiectasia, and visceral shunts with arteriovenous defects. It is pregnancy that contributes to the proliferation and growth of VAM.

Our patient is a 32-year-old female from a low social class and married for 7 years. She has already lost her fetus after 4 years ago, and she had already undergone miscarriage after 16 AW 2 years ago. One year after, she suffered from epistaxis two times, and she was put in medical reanimation after 15 days following her pregnancy. She gave birth to her baby boy vaginally. The progression of the disease was noticed two days after the installation of headache in helmets with epigastric pain in irradiating strips towards the right hypochondrium.

The physical examination revealed a high blood pressure that reaches in the right limb and 155/90 mmHg in the left one, labstix: 2 proteinuria crosses, and stable in respiration. Moreover, the patient has epigastric sensitivity and telangiectasia in both the trunk and the sublingual area. An abdominal ultrasound scan was conducted to look for a subcapsular hematoma of the liver that returned in favour of a hypoechogenic lesion in segments VII and II of the liver and which was complemented by an angioscanner that showed vascular abnormalities in the lung and the liver . Encephalic MRI is positive.

Oesophagogastroduodenoscopy was conducted in favour of the following:

erythematous and nodular antritis

Antral millimetric telangiectasia lesion that bleeds

Telangiectasic lesions scattered in both the bulb and the duodenum.

Treatment is based on treating preeclampsia using oral antihypertensives (nicardipine 50 mg 2x/day) and proton pump inhibitors per bone 40 mg/day.The patient’s situation was improved after two days of treatment in that the pain disappeared.

Conclusively, MRO is marked by spontaneous epistaxis, mucocutaneous telangiectasia, and visceral arteriovenous defects (lung, liver, digestive tract, and brain).The therapy includes a screening of visceral arteriovenous malformations and treatments to prevent their complications.

Source: https://www.hindawi.com/journals/criog/2020/2746947/
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