Osler-Weber-Rendu Disease Uncovered by Preeclampsia
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Osler-Weber-Rendu disease (OWRD), called hereditary hemorrhagic telangiectasia, is an uncommon genetic illness with the dominant autosomal transmission. It cannot be easily or quickly diagnosed because of both its infrequency and its various associated symptoms. As far as its symptoms are concerned, the patient experiences recurring epistaxis, mucocutaneous telangiectasia, and arteriovenous malformations that can lead to severe undesirable symptoms.

A 32-year-old female from a low social class and married for 7 years. She has already lost her fetus after 34 AW 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 TA = 150/80 mmHg in the right limb and 155/90 mmHg in the left one, FC = 90 bpm, 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 favor 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 favor 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.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081023/
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