title: Blessing for the bleeder: bevacizumab in hereditary hemorrhagic telangiectasia.
abstract: Hereditary hemorrhagic telangiectasia (HHT) is a genetic disorder characterized by uncontrolled multisystem angiogenesis with epistaxis, gastrointestinal bleeding, iron-deficiency anemia, and arteriovenous malformations, and is often associated with increased levels of vascular endothelial growth factor (VEGF). Bevacizumab, a VEGF inhibitor, reduces epistaxis, telangiectasias, and iron-deficiency anemia. We present the case of a woman with HHT and chronic gastrointestinal bleeding who required iron supplementation and multiple blood transfusions. Bevacizumab resulted in marked symptom improvement and transfusion-independence. Our report describes the dose schedule and calls for a randomized, controlled trial demonstrating the value of bevacizumab therapy.
authors.affiliation: Department of Internal Medicine, Marshfield Clinic, Marshfield, Wisconsin, USA nepperla@mcw.edu.
authors.forename: Narendranath
authors.initials: N
authors.lastname: Epperla
authors.affiliation: Department of Hematology-Oncology, Marshfield Clinic, Marshfield, Wisconsin, USA.
authors.forename: William
authors.initials: W
authors.lastname: Hocking
mesh_terms: D000068258:Bevacizumab / Q000008:administration & dosage*; D002908:Chronic Disease; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000097:blood / Q000188:drug therapy*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: Bevacizumab; Dosing; Epistaxis; Hereditary hemorrhagic telangiectasia (HHT)