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伴有多部位耳鼻喉表现的遗传性出血性毛细血管扩张症:一例报告

Hereditary Hemorrhagic Telangiectasia With Multiple Ear, Nose, and Throat (ENT) Manifestations: A Case Report.

作者信息

Litsou Eleni, Basiari Lentiona, Tsirves Georgios, Psychogios Georgios V

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Ioannina, Ioannina, GRC.

出版信息

Cureus. 2023 Jul 30;15(7):e42706. doi: 10.7759/cureus.42706. eCollection 2023 Jul.

Abstract

Hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is a rare autosomal dominant multisystem disorder. It is a mucocutaneous and fibrovascular dysplasia, the diagnosis of which is based on the fulfillment of the four Curaçao criteria: 1) recurrent epistaxis; 2) dermatovascular mucosal telangiectasias at characteristic sites: skin of the face, ears, fingertips, lips, tongue, and oral and nasal cavity; 3) arteriovenous malformations (AVMs) of visceral organs and central nervous system; and 4) family history: diagnosis of HHT in a first-degree relative. We describe a case of a 76-year-old patient who presented to our department with clinical manifestations of HHT in the skin (face, fingertips), lips, hard palate, tongue, ears, and nasal cavities. Individual and family history was obtained, as well as clinical laboratory examination, pan-endoscopy of the ear, nose, and throat (ENT) systems, and treatment of active foci of bleeding from the above areas. The otolaryngologist may be the first doctor to suspect Rendu-Osler-Weber syndrome and the one responsible for treating patients with HHT since recurrent epistaxis is the most frequent (90-96% of patients) and the earlier manifestation of the disease and the main reason for the arrival of these patients in the Emergency Department. The purpose of this study is to present a clinical case of Rendu-Osler-Weber syndrome with multiple ENT manifestations, as well as a review of the literature on their management and treatment.

摘要

遗传性出血性毛细血管扩张症(HHT),又称伦杜-奥斯勒-韦伯综合征,是一种罕见的常染色体显性多系统疾病。它是一种黏膜皮肤和纤维血管发育异常疾病,其诊断基于满足库拉索岛标准的四项内容:1)反复鼻出血;2)在特征性部位出现皮肤血管黏膜毛细血管扩张:面部、耳部、指尖、嘴唇、舌头以及口腔和鼻腔的皮肤;3)内脏器官和中枢神经系统的动静脉畸形(AVM);4)家族史:一级亲属中有HHT诊断病例。我们描述了一例76岁患者,该患者因皮肤(面部、指尖)、嘴唇、硬腭、舌头、耳部和鼻腔出现HHT临床表现前来我科就诊。收集了个人史和家族史,进行了临床实验室检查、耳鼻喉(ENT)系统的全内镜检查以及对上述部位活动性出血病灶的治疗。耳鼻喉科医生可能是首个怀疑伦杜-奥斯勒-韦伯综合征的医生,也是负责治疗HHT患者的医生,因为反复鼻出血是该病最常见的症状(90 - 96%的患者有此症状),且是疾病的早期表现以及这些患者前往急诊科就诊的主要原因。本研究的目的是呈现一例具有多种耳鼻喉科表现的伦杜-奥斯勒-韦伯综合征临床病例,并对其管理和治疗的文献进行综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4e5/10467641/e41792c06d33/cureus-0015-00000042706-i01.jpg

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