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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gastrointestinal bleeding is one of the most common problems confronting the physician. In most instances, the source of the bleeding is easily identified, e.g., peptic ulcer disease, bleeding esophageal varices or a colonic lesion. Recurrent gastrointestinal bleeding, however, represents one of the major enigmas confronting the practicing physician. The patient experiences intermittent episodes of weakness, easy fatigability and anemia with occult blood in the stool. Multiple barium radiographic examinations and often endoscopy and exploratory laparotomy are unrevealing as to the etiology of the bleeding. We have had occasion to investigate three such patients. Multiple evaluations of these individuals did not reveal the source of the bleeding until many years later--Rendu-Osler-Weber Disease (ROW). At the time of their evaluations these patients did not reveal the usual telangiectatic areas present on the skin and oral mucous membrane. The diagnosis was suggested by the presence of multiple gastric mucosal telangiectasia identified by gastroscopic examination. This report emphasizes the need for thorough endoscopic evaluation of patients with gastrointestinal bleeding and describes the gastroscopic findings that indicated hereditary telangiectasia as the probable source of bleeding from the gastrointestinal tract.
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PMID:Hereditary telangiectasia manifested as gastrointestinal bleeding without external visible telangiectasia. 107 4

A 46-year-old woman was admitted to the hospital because of dyspnea and palpitation. Physical examination showed severe anemia and cardiac distress. Telangiectases were found in the conjunctivas, lips and oral mucosa. Chest roentogenogram showed an enlarged cardiac silhoutte and multiple coin lesions in both lower lung fields. We diagnosed her as Rendu-Osler-Weber disease (ROW). The angiographic studies showed hemangioma in the foramen of Monro, bilateral multiple pulmonary arteriovenous fistulas, and hepatic arteriovenous fistula with a large distortion of the proper hepatic artery. Although associated vascular dysplasias have been described in patients with ROW, there is no reports on ROW in which multiple vascular abnormalities concomitantly existed such as the present case. In 163 detailed cases of ROW in Japan, the frequency of vascular lesions was summarized, and this result showed that the vascular lesions of the lung were more frequent than that of the liver or brain, in comparison with countries in Europe and America. It is very important for diagnosis and its prognosis to perform a detailed angiographic examinations and to demonstrate the precise sites of the vascular dysplasias in patients with ROW.
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PMID:A case of Rendu-Osler-Weber disease with cerebral hemangioma, multiple pulmonary arteriovenous fistulas and hepatic arteriovenous fistula. 258 96

Microangiopathic haemolytic anaemia was diagnosed in the course of haematopoietic and lymphatic disorders such as chronic granulocytic leukemia, chronic myelofibrosis, chronic lymphatic leukemia, Osler's disease, chronic monocytic leukemia, and lymphoplasmocytic lymphoma, in 11 patients (6 women and 5 men) aged between 33 and 81 years (mean age 58.8 years) treated at the Haematological Out-Patient Clinic of the Postgraduate Medical Education Centre within 1977-1987. The following laboratory tests were carried out: 1) morphology of the peripheral blood and bone marrow, especially some haematological parameters concerning erythrocytes and blood platelets; 2) biochemical tests reflecting erythrocytes disintegration; 3) haemostasis. All examined patients suffered from haemolytic anaemia of various degree with characteristic changes in erythrocyte shape (helmets, tear-drops etc.). Haemolytic origin of anaemia was confirmed by the increased LDH activity. In the majority of patients no compensative stimulation of haematopoiesis (reticulocytosis, red blood cells hyperproliferation in bone marrow) was seen. Clinical symptoms of haemostatic disorders such as haemorrhagic diathesis and vein thrombosis were diagnosed in 50% of the patients. Blood platelet counts ranged from markedly decreased to significantly increased. Bone marrow smears did not show increased number of megacariocytes. Bleeding time was prolonged in the majority of examined patients while prothrombin index--decreased). Abnormal fibrinogen levels (decreased or increased) were found in the majority of patients with fibrin degradation products. Microangiopathic haemolytic anaemia in these patients differ from the typical Moschowitz's disease clinically probably due to the lack of compensative stimulation of erythropoiesis and lower thrombocytopenia.
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PMID:[Microangiopathic hemolytic anemia in patients with diseases of the hematopoietic and lymphatic systems]. 262 5

Over a 3-year period, arteriovenous malformations (angiodysplasia) were identified at upper gastrointestinal endoscopy in 41 patients. The lesions were multiple in one-third of patients and were predominantly situated in the proximal stomach. We considered angiodysplasia to be the cause of upper gastrointestinal bleeding in 11 (27%) patients and of anemia in nine (22%) patients. In these two groups other mucosal lesions were not seen at upper gastrointestinal endoscopy and there had been prior undiagnosed episodes of overt or occult bleeding in almost half. In 21 (51%) patients the lesions were judged to be incidental findings. Other medical conditions noted were the presence of an aortic systolic murmur (24%) and renal impairment (12%). Only three patients had mucocutaneous telangiectasia (two had Osler-Rendu-Weber syndrome, and one had scleroderma with CRST syndrome). Specific treatment in 14 symptomatic patients included endoscopic electrocoagulation or injection sclerotherapy. In eight patients with adequate post-treatment surveillance, endoscopy demonstrated obliteration of the vascular lesions.
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PMID:Angiodysplasia of the upper gastrointestinal tract. Clinical spectrum in 41 cases. 348 50

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is a bleeding disorder attributed to a vascular developmental abnormality. It is transmitted as an autosomal dominant trait. A 63-year-old female was admitted because of repeated episodes of severe anemia which resulted from bleeding of telangiectases in the gastric mucosa. Conventional therapies including endoscopical microwave coagulation and ethanol injection were not effective. The persistent anemia necessitated frequent blood transfusion. Estrogen was orally administrated and blood transfusion became unnecessary. Thus, estrogen therapy should be considered as one of the effective treatments for recurrent severe anemia due to hereditary hemorrhagic telangiectasia.
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PMID:Hereditary hemorrhagic telangiectasia showing severe anemia which was successfully treated with estrogen. 754 50

Hereditary haemorrhagic telangiectasia (HHT) or Rendu-Osler-Weber disease is an autosomal dominant vascular disorder which associates epistaxis, mucocutaneous and visceral telangiectases, and recurrent haemorrhage with chronic anaemia and visceral shuntings. Recently, the tumour growth factor (TGF)-beta binding protein endoglin localized to 9q33-34 was identified as responsible for HHT in several large kindreds with pulmonary arteriovenous malformations (PAVMs). Additional linkage studies demonstrated that HHT is a genetically heterogeneous disorder with families unlinked to this region of 9q. In the families in which HHT was not linked to chromosome 9, less PAVMs were present. Furthermore, in one of these families, HHT was found linked to 3p22, where the TGF-beta II receptor is located. In this linkage study, we have analysed DNA from two families, in which HHT was unlinked to chromosome 9q and 3p, and PAVMs were absent, with a series of genetic markers on the centromeric region of chromosome 12. Using two-point linkage analysis, a significant lod score of Zmax = 7.86 at theta = 0.05 was obtained with the D12S85 microsatellite marker.
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PMID:A third locus for hereditary haemorrhagic telangiectasia maps to chromosome 12q. 763 56

A 77-year-old male having multiple small nevi over the lips, face, mucous membrane of mouth, tongue, neck and thorax was admitted to our hospital because of severe anemia. He has been diagnosed as Rendu-Osler-Weber disease (Osler's disease) since his 42 years of age. Although the stools were positive for occult blood, hematologic examination disclosed no abnormalities except for severe hypochromic and microcytic anemia. Gastrointestinal examination showed multiple stigmata in the esophagus, stomach, duodenum, and several tumors in the colon. Histological findings of biopsy specimens obtained from these tumors revealed adenocarcinomas and tubular adenomas. Surgical resection was carried out. Resected specimens showed two tumors (one is in ascending colon appeared to be 2 type carcinoma, 1.9 x 2.3 cm in size, another is in caecum, 3 type, 7.0 x 5.0 cm in size) and three Yamada-II approximately III type polyps. Pathohistologically, the tumor in ascending colon showed moderately differentiated adenocarcinoma, another one in caecum showed mucinous carcinoma, and polyps showed tubular adenomas, respectively. Unfortunately, the anemia of this case was regarded as stemming from Osler's disease, so the precise gastrointestinal examination was not performed for a long time. It should be emphasized to be faithful to the fundamentals of medical diagnosis.
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PMID:[A case of Rendu-Osler-Weber disease associated with simultaneous, multiple advanced cancers in the colon]. 770 55

Severe and recurrent epistaxis in cases of Rendu-Osler disease (Hereditary hemorrhagic telangiectasia) are very difficult to treat. For one case the authors propose a bilateral nasolabial flap with inferior pedicle. They describe the technique and after 15 months of follow-up there is no recurrency. This treatment is used for particular cases: old people with short expectation of life, severe anaemia involving the vital prognosis.
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PMID:[treatment of an epistaxis using a bilateral nasolabial flap in Osler-Rendu disease]. 863 56

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu) disease is characterized by cutaneous, mucosal, and visceral vascular anomalies. Two patients were previously described with coronary artery aneurysms (ectasia) associated with this disease. This report describes a patient with Osler-Weber-Rendu disease in whom multiple coronary arteriovenous malformations were identified during coronary angiography. The patient presented with anginal chest pain resulting from severe anemia. Upper gastrointestinal endoscopy revealed multiple angiodysplastic lesions throughout the esophagus and stomach.
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PMID:Coronary arteriovenous malformations in a patient with hereditary hemorrhagic telangiectasia--a case report. 967 58

We report the history of a 77-year-old man with Osler-Weber-Rendu disease (hereditary hemorrhagic telangiectasia) who suffered from recurrent epistaxis and chronic bleeding anemia for many years. Hereditary hemorrhagic telangiectasia is a rare congenital disease, that is characterized by telangiectases of the nasal and oral mucosa, the gastrointestinal tract and the skin. Arteriovenous malformations of the lung and the brain may be present. The genetic and pathologic features, the clinical manifestations and the differential diagnosis are shortly presented. The management is not validated by controlled studies and is mainly based on clinical experience. It involves supportive therapy with iron supplementation and erythrocyte transfusions, if needed, for chronic bleeding anemia, aminocaproic acid, tranexamic acid or oestrogen-progesterone therapy to prevent mucosal bleeding, cauterisation, photocoagulation, transcatheter embolotherapy or surgery to treat the vascular abnormalities.
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PMID:[Chronic, hemorrhage-induced iron deficiency anemia in Osler disease]. 1051 26


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