Document Detail

Twenty-four-hour and annual variation in onset of epistaxis in Osler disease.
MedLine Citation:
PMID:  17453853     Owner:  NLM     Status:  MEDLINE    
Osler disease is an autosomal dominant disorder of the fibrovascular tissue characterized by arteriovenous malformations with multi-systemic haemorrhages. Recurrent epistaxis is the predominant symptom in more than 90% of patients. Recent studies showed circadian and seasonal patterns in the onset of nosebleeds, similar to acute cardiovascular events, such as myocardial infarction and stroke. The aim of this study was to determine whether such patterns would also apply to the onset of epistaxis in patients with Osler disease. In all, 110 patients with Osler disease who were under treatment for recurrent epistaxis at the University Hospital of Mannheim were requested to complete a questionnaire addressing the intensity and frequency of epistaxis according to the classification of Bergler et al., as well as circadian and circannual rhythmicity in the occurrence of epistaxis according to visual analogue scales (VAS). More than half of the patients claimed to experience daily to weekly episodes of recurrent epistaxis. The occurrence of epistaxis showed a biphasic 24 h pattern, with a primary peak in the morning (05:00-8:00 h) and smaller secondary peaks in the evening (17:00-20:00 h and 21:00-00:00 h). No significant seasonal variation was found in the onset of epistaxis. However, a slight tendency, with a peak in winter months, was observed. Similar to other chronobiological studies on nosebleeds, this study showed that the 24 h pattern and seasonal tendency in the onset of epistaxis even applied to patients with Osler disease. Further investigations are necessary to determine the pathological mechanism underlying this phenomenon.
Haneen Sadick; Inigo Fleischer; Ulrich Goessler; Karl Hörmann; Maliha Sadick
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chronobiology international     Volume:  24     ISSN:  0742-0528     ISO Abbreviation:  Chronobiol. Int.     Publication Date:  2007  
Date Detail:
Created Date:  2007-04-24     Completed Date:  2007-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501362     Medline TA:  Chronobiol Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-64     Citation Subset:  IM    
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Mannheim, Mannheim, Germany.
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MeSH Terms
Aged, 80 and over
Circadian Rhythm / physiology*
Epistaxis / etiology*,  physiopathology*
Middle Aged
Telangiectasia, Hereditary Hemorrhagic / complications*,  physiopathology*

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