title: The value of screening for multiple arterio-venous malformations in hereditary hemorrhagic telangiectasia: a diagnostic study.
abstract: Occult visceral arterio-venous malformations (AVMs) may be a constant threat to patients suffering from hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome (M. ROW). HHT patients predominantly become symptomatic through chronic, recurrent epistaxis, a symptom that can alert physicians at an early stage of the disease. The purpose of this study was to investigate whether occult, visceral arterio-venous malformations could be detected by screening imaging studies in patients suffering from HHT. In a comprehensive diagnostic study, Rendu-Osler-Weber patients were examined for potential visceral arterio-venous malformations by physical examination and non-invasive imaging techniques. The Department of Otolaryngology of the Philipps University of Marburg is a major referral center and coordinated the screening procedures. Thirty-five individuals with the presumed diagnosis of HHT gave informed consent to the screening investigations. Eighteen of 35 individuals were found to suffer from visceral vascular malformations; most of the AVMs were diagnosed in the lung, but also the liver, spleen, brain and eyes were affected. Six patients could be treated preventively by arterial embolization for AVMs of the lung, liver and brain. Comprehensive screening for occult AVMs in HHT patients seems to be justified to avert potential complications in this group of patients.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Philipps University of Marburg, Deutschhausstr. 3, 35037, Marburg, Germany. folz@med.uni-marburg.de
authors.forename: Benedikt J
authors.initials: BJ
authors.lastname: Folz
authors.forename: Ana Cerra
authors.initials: AC
authors.lastname: Wollstein
authors.forename: Heiko
authors.initials: H
authors.lastname: Alfke
authors.forename: Anja A
authors.initials: AA
authors.lastname: Dünne
authors.forename: Burkard M
authors.initials: BM
authors.lastname: Lippert
authors.forename: Konrad
authors.initials: K
authors.lastname: Görg
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Wagner
authors.forename: Siegfried
authors.initials: S
authors.lastname: Bien
authors.forename: Jochen A
authors.initials: JA
authors.lastname: Werner
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001165:Arteriovenous Malformations / Q000175:diagnosis* / Q000453:epidemiology*; D002533:Cerebral Angiography / Q000379:methods; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000175:diagnosis* / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color