Document Detail


Symptomatic liver involvement in neonatal hereditary hemorrhagic telangiectasia.
MedLine Citation:
PMID:  21536610     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High-flow hepatic vascular anomalies with arteriovenous shunting commonly manifest during the neonatal period with signs and symptoms of congestive heart failure, but to our knowledge, they have never been described in patients with hereditary hemorrhagic telangiectasia (HHT). We report here our experience with 3 patients with hepatic arteriovenous malformations (AVMs) who presented with symptoms of high-output congestive heart failure during the neonatal period and were subsequently diagnosed with HHT. Imaging showed large hypervascular lesions and multiple hepatic arteriovenous shunts that differentiated these lesions from liver hemangiomas. Transcatheter embolization was performed in all cases. One infant died of sepsis shortly after embolization; follow-up at the age of 2.5 years of the surviving infants revealed involution of the vascular lesions and no evidence of symptom recurrence. We conclude that severe symptoms related to hepatic AVMs in HHT can occur in the neonatal period and that HHT should therefore be included in the differential diagnosis of symptomatic neonatal hepatic vascular malformations. Imaging plays a key role in differentiating hepatic AVMs from hemangiomas, because the latter require additional pharmacologic treatments. Early transcatheter embolization seems to be effective, but long-term outcomes still need to be assessed.
Authors:
Suhail Al-Saleh; Philip R John; Michelle Letarte; Marie E Faughnan; Jaques Belik; Felix Ratjen
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-05-02
Journal Detail:
Title:  Pediatrics     Volume:  127     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-02     Completed Date:  2011-08-09     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1615-20     Citation Subset:  AIM; IM    
Affiliation:
University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Angiography
Diagnosis, Differential
Embolization, Therapeutic / methods
Female
Follow-Up Studies
Humans
Infant, Newborn
Liver / blood supply*,  radiography,  ultrasonography
Liver Diseases / diagnosis,  etiology*,  therapy
Male
Telangiectasia, Hereditary Hemorrhagic / complications*
Vascular Malformations / complications*,  diagnosis,  therapy
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research
Comments/Corrections

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