# Unmasking a Rare Genetic Puzzle: Hereditary Hemorrhagic Telangiectasia in a Black Kenyan Woman: A Case Report

**Authors:** Lavender Otom, Priyanka Panwar, Farida Kaittany, Ben Clement Lomatayo

PMC · DOI: 10.1155/crgm/3692365 · Case Reports in Gastrointestinal Medicine · 2026-02-23

## TL;DR

This case report describes a rare genetic disorder, HHT, in a Black Kenyan woman, highlighting the challenges of diagnosis and treatment in low-resource settings.

## Contribution

This is the first documented case of HHT with upper gastrointestinal bleeding in Western Kenya.

## Key findings

- A 57-year-old Black Kenyan woman presented with upper gastrointestinal bleeding due to HHT.
- Diagnosis was made through clinical evaluation despite limited resources.
- Treatment included blood transfusions, iron, and tacrolimus to manage bleeding.

## Abstract

Hereditary hemorrhagic telangiectasia (HHT) is a rare genetic disorder characterized by mucocutaneous and visceral telangiectasias, often leading to severe complications. This case report presents an uncommon manifestation of HHT in a 57‐year‐old Black Kenyan female with upper gastrointestinal bleeding. Given the rarity of HHT in our region, this case underscores the importance of early recognition, particularly in resource‐limited settings, to improve patient outcomes.

A 57‐year‐old Black Kenyan female presented with recurrent upper gastrointestinal bleeding. Endoscopy revealed multiple telangiectatic lesions in the stomach and duodenum, with an actively bleeding duodenal telangiectasia. Despite limited diagnostic resources, a thorough history and focused clinical examination led to the diagnosis of HHT. She was managed with blood transfusions, intravenous iron, tranexamic acid, and supportive therapy to control bleeding. Systemic therapy with low‐dose tacrolimus was later initiated for recurrent gastrointestinal bleeding. This case illustrates the diagnostic and therapeutic challenges faced in a low‐resource setting.

This is the first documented case of HHT with upper gastrointestinal bleeding reported in Western Kenya. Raising awareness of this rare condition among healthcare providers can facilitate early diagnosis and intervention, ultimately improving patient outcomes.

## Linked entities

- **Chemicals:** tacrolimus (PubChem CID 445643), tranexamic acid (PubChem CID 5526), iron (PubChem CID 23925)
- **Diseases:** Hereditary hemorrhagic telangiectasia (MONDO:0019180)
- **Species:** Homo sapiens (taxon 9606)

## Full-text entities

- **Genes:** TGFB2 (transforming growth factor beta 2) [NCBI Gene 7042] {aka CAEND2, G-TSF, LDS4, TGF-beta2}, ENG (endoglin) [NCBI Gene 2022] {aka END, HHT1, ORW1}, GDF2 (growth differentiation factor 2) [NCBI Gene 2658] {aka BMP-9, BMP9, HHT5}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, RASA1 (RAS p21 protein activator 1) [NCBI Gene 5921] {aka CM-AVM, CMAVM, CMAVM1, GAP, PKWS, RASA}, SMAD4 (SMAD family member 4) [NCBI Gene 4089] {aka DPC4, JIP, MADH4, MYHRS}, BMP1 (bone morphogenetic protein 1) [NCBI Gene 649] {aka OI13, PCOLC, PCP, TLD}, BMPR2 (bone morphogenetic protein receptor type 2) [NCBI Gene 659] {aka BMPR-II, BMPR3, BMR2, BRK-3, POVD1, PPH1}, ACVRL1 (activin A receptor like type 1) [NCBI Gene 94] {aka ACVRLK1, ALK-1, ALK1, HHT, HHT2, ORW2}
- **Diseases:** iron deficiency (MESH:D000090463), visceral lesions (MESH:D007418), telangiectatic lesions (MESH:D001816), blood loss (MESH:D016063), focal nodular hyperplasia (MESH:D020518), Gastrointestinal bleeds (MESH:D006471), colonic telangiectasia (MESH:D003108), vascular masses (MESH:C536030), hereditary coagulopathies (MESH:D025861), gastrointestinal side effects (MESH:D064420), Pulmonary AVMS (MESH:D008171), bacteremia (MESH:D016470), vascular abnormalities (MESH:D014652), rupture (MESH:D012421), emboli (MESH:D020766), gastrointestinal mucosal lesions (MESH:D005767), air embolism (MESH:D004618), cerebral abscesses (MESH:D001922), cancers (MESH:D009369), iron-deficiency anemia (MESH:D018798), hepatic angiomas (MESH:D006391), HHT (MESH:D013683), biliary necrosis (MESH:D009336), juvenile polyposis (MESH:C537702), hemic murmur (MESH:D006425), strictures (MESH:D003251), dyspnea (MESH:D004417), autosomal dominant disorder (MESH:D030342), stroke (MESH:D020521), hepatomegaly (MESH:D006529), hemothorax (MESH:D006491), hepatic encephalopathy (MESH:D006501), melena (MESH:D008551), hemoptysis (MESH:D006469), pulmonary and liver vascular malformations (MESH:D017093), palpitations (MESH:D006331), jaundice (MESH:D007565), von Willebrand's disease (MESH:D014842), fatigue (MESH:D005221), hepatic lesions (MESH:D056486), like (MESH:C537419), epistaxis (MESH:D004844), Cerebral AVMs (MESH:D002538), bowel perforation (MESH:D057112), vascular malformation (MESH:D054079), cirrhosis (MESH:D005355), nonhepatocellular lesions (MESH:D009059), presyncope (MESH:D013575), tachycardia (MESH:D013610), AVMs (MESH:D001165), GI bleeding (MESH:D006470), septal perforation (MESH:D018658), GI telangiectasias (MESH:D013684), ascites (MESH:D001201), injury (MESH:D014947), anemia (MESH:D000740), shock (MESH:D012769), duodenal lesion (MESH:D004378), hematemesis (MESH:D006396), ischemic attacks (MESH:D002546)
- **Chemicals:** pomalidomide (MESH:C467566), Argon (MESH:D001128), Bevacizumab (MESH:D000068258), lenalidomide (MESH:D000077269), progesterone (MESH:D011374), thalidomide (MESH:D013792), tamoxifen (MESH:D013629), tacrolimus (MESH:D016559), iron (MESH:D007501), raloxifene (MESH:D020849), tranexamic acid (MESH:D014148), saline (MESH:D012965), ferrous carboxymaltose (-), gadolinium (MESH:D005682)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

44 references — full list in the complete paper: https://tomesphere.com/paper/PMC12927944/full.md

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Source: https://tomesphere.com/paper/PMC12927944