Authors: Christine Priscilla Edwards Nadine Shehata Marie E Faughnan
Publish Date: 2012/09/30
Volume: 91, Issue: 12, Pages: 1959-1968
Abstract
Hereditary hemorrhagic telangiectasia HHT is an autosomal dominant disorder characterized by arteriovenous malformations AVMs and hemorrhage HHT patients can also suffer from unrelated medical conditions requiring anticoagulant or antiplatelet treatment collectively “AT” though clinicians generally consider HHT a contraindication to AT We hypothesized that HHT patients can tolerate AT with minimal hemorrhage Through a chart review of 469 definite HHT patients 1997–2009 we found that 64 14 had received AT Fortythree out of 64 67 underwent a telephone survey to retrospectively inquire about prescription early cessation and HHTrelated bleeding At the time of the study nine patients were deceased nine declined and three were unreachable During AT treatment ten 23 reported severe complications blood transfusion emergency room visit or hospital admission while 25 58 reported minor complications increase or development of epistaxis gastrointestinal bleeding and anemia No patients reported pulmonary/cerebral hemorrhage The 43 patients received a total of 69 courses of AT Fourteen out of 69 20 AT courses in 13 patients required early cessation mostly due to epistaxis Two out of nine 22 deceased patients required early cessation We conclude that HHT patients can be treated with AT but should be monitored closely given their risk for worsening chronic bleeding and should be screened/treated for pulmonary or cerebral AVMs prior to AT treatment
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