A 45-Year-Old Woman With Hereditary Hemorrhagic Telangiectasia and Persistent Exertional Dyspnea and Peripheral Edema

TL;DR

A 45-year-old woman with hereditary hemorrhagic telangiectasia and severe anemia was treated with bevacizumab to manage her condition.

Contribution

The paper presents a novel application of bevacizumab in managing severe anemia caused by gastrointestinal telangiectasias in hereditary hemorrhagic telangiectasia.

Findings

The patient had severe anemia due to gastrointestinal telangiectasias and required 27 blood transfusions.

Bevacizumab treatment was initiated and administered over 8 cycles to manage her condition.

The patient had a history of multiple embolizations for gastrointestinal and pulmonary arteriovenous malformations.

Abstract

We report the case of a 45-year-old woman who was referred to our Cardiology Department because of persistent exertional dyspnea and peripheral edema. She had an established clinical diagnosis of hereditary hemorrhagic telangiectasia with multiple gastrointestinal telangiectasias that had been submitted to repeat embolization in the past and arteriovenous malformations in the liver and lungs. Complete blood count was diagnostic for severe anemia (hemoglobin 5-6 g/dL). Since the hereditary hemorrhagic telangiectasia diagnosis 3 years prior, the patient informed us that she has undergone 27 blood transfusions and multiple embolizations to manage gastrointestinal telangiectasias. Given her severe anemia that was caused by gastrointestinal telangiectasia, treatment with bevacizumab was initiated. Bevacizumab was administered over 8 cycles (initially biweekly for 4 doses, followed by monthly administration).

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