EPISTAXIS, HEREDITARY HAEMORRHAGIC TELANGIECTASIA AND IRON DEFICIENCY ANEMIA.

AHMED N¹, HLA AYE MT², CHOO S¹, MANI BI², KEASBERRY J¹, CHONG VH^1,2

¹Acute Medical Unit, Department of Medicine, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam.

²Department of Medicine, PMMPMHAMB Hospital, Jalan Sungai Basong, Tutong, Brunei Darussalam.

ABSTRACT

Iron deficiency anemia is commonly encountered in clinical practice and the underlying etiology can be benign or pathological, depending on the gender and age of patients. Common causes include pre-menopausal menstrual and gastrointestinal blood loss. However, it is important to be aware of less common causes. Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu syndrome is disorder of vascular malformations that can affect any site. Hereditary hemorrhagic telangiectasia often manifest with chronic blood loss resulting in iron deficiency anemia. Telangiectasias affecting the hands and oral cavity can be easily detected on careful examination but can be overlooked. Vascular malformations affecting other sites such liver, lungs and brain require radiological imaging. We report two cases of hereditary hemorrhagic telangiectasia and iron deficiency anemia secondary to recurrent epistaxis, one patient requiring only iron supplementation to maintain hemoglobin level and another requiring frequent transfusion. 

Keywords: Arteriovenous malformations, Epistaxis, Gastrointestinal blood loss, Iron deficiency anemia.

Corresponding author: Dr Justin Fook Siong Keasberry, General and Acute Medicine Physician, Acute Medical Unit, Department of Medicine, RIPAS Hospital, Jalan Putera Al-Muhtadee Billah, Bandar Seri Begawan BA1712, Brunei Darussalam.

E mail: jkeasberry@hotmail.com / justin_keasberry@moh.gov.bn ; Phone: +6732242424

Brunei Int Med J.2022;18:34-38