Huge Pulmonary Arteriovenous Malformation, Venous Thromboembolism and Anticoagulation Treatment in a Patient with Hereditary Hemorrhagic Telangiectasia

Intern Med. 2015;54(21):2745-8. doi: 10.2169/internalmedicine.54.4540. Epub 2015 Nov 1.

Abstract

Hereditary hemorrhagic telangiectasia (HHT) usually presents in association with pulmonary arteriovenous malformations (PAVMs). In addition, the incidence of venous thromboembolism tends to be increased in these patients. A 74-year-old female with HHT presented with cyanosis and hypoxemia. Contrast-enhanced multislice computed tomography (MSCT) revealed two left PAVMs and one in the right upper lobe. Both left PAVMs were treated with embolotherapy. Follow-up MSCT revealed an incidental pulmonary embolism in the right pulmonary branches. Deep venous thrombosis was confirmed and anticoagulation was initiated. Follow-up MSCT revealed the resolution of thromboembolism. Finally, embolotherapy was performed. This case illustrates the chronic adaptation to hypoxemia and adds further evidence to the relative safety of anticoagulation treatment in these patients.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticoagulants / administration & dosage*
  • Arteriovenous Malformations / diagnostic imaging
  • Arteriovenous Malformations / etiology*
  • Arteriovenous Malformations / therapy
  • Cyanosis / etiology
  • Embolization, Therapeutic* / methods
  • Female
  • Humans
  • Hypoxia / etiology
  • Incidence
  • Multidetector Computed Tomography*
  • Telangiectasia, Hereditary Hemorrhagic / complications*
  • Telangiectasia, Hereditary Hemorrhagic / diagnostic imaging
  • Telangiectasia, Hereditary Hemorrhagic / therapy
  • Treatment Outcome
  • Venous Thromboembolism / diagnostic imaging
  • Venous Thromboembolism / etiology*
  • Venous Thromboembolism / therapy

Substances

  • Anticoagulants