Intracranial hemorrhage in infants and children with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome).

Terry Morgan, Jamie McDonald, Christina Anderson, Magdy Ismail, Franklin Miller, Rong Mao, Ashima Madan, Patrick Barnes, Louanne Hudgins, Melanie Manning

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

OBJECTIVE: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular dysplasia. Most cases are caused by mutations in the endoglin gene on chromosome 9 (HHT type 1) or the activin receptor-like kinase 1 gene on chromosome 12 (HHT type 2), which leads to telangiectases and arteriovenous malformations (AVM) of the skin, mucosa, and viscera. Epistaxis is the most frequent presentation. Visceral involvement includes pulmonary, gastrointestinal, and cerebral AVMs, which have been reported predominantly in adults. The purpose of this article is to describe 9 children who presented with intracranial hemorrhage (ICH) secondary to cerebral AVM. None of these children was suspected of having HHT before the incident, despite family histories of the disease. METHODS: We report the first case of an ICH secondary to a cerebral AVM in a neonate confirmed to have HHT type 1 by molecular analysis. We also describe a series of 8 additional cases of ICH secondary to cerebral AVM in children presumed to have HHT. Examination of multiple affected members from each of these families, using well-accepted published criteria, confirmed the diagnosis of HHT. In addition, genetic linkage studies and/or mutation analysis identified endoglin as the disease-causing gene in 6 of these families. Autopsy, imaging studies, and/or surgery confirmed the presence of cerebral AVMs and ICH in all 9 cases. CONCLUSION: Our report shows that infants and children with a family history of HHT are at risk for sudden and catastrophic ICH. A preemptive diagnosis may potentially identify and prevent more serious sequelae.

Original languageEnglish (US)
JournalPediatrics
Volume109
Issue number1
StatePublished - Jan 2002
Externally publishedYes

Fingerprint

Hereditary Hemorrhagic Telangiectasia
Intracranial Hemorrhages
Intracranial Arteriovenous Malformations
Activin Receptors
Genes
Chromosomes, Human, Pair 12
Telangiectasis
Chromosomes, Human, Pair 9
Mutation
Epistaxis
Genetic Linkage
Viscera
Arteriovenous Malformations
Cerebral Hemorrhage
Blood Vessels
Autopsy
Mucous Membrane
Newborn Infant
Lung
Skin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Morgan, T., McDonald, J., Anderson, C., Ismail, M., Miller, F., Mao, R., ... Manning, M. (2002). Intracranial hemorrhage in infants and children with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome). Pediatrics, 109(1).

Intracranial hemorrhage in infants and children with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome). / Morgan, Terry; McDonald, Jamie; Anderson, Christina; Ismail, Magdy; Miller, Franklin; Mao, Rong; Madan, Ashima; Barnes, Patrick; Hudgins, Louanne; Manning, Melanie.

In: Pediatrics, Vol. 109, No. 1, 01.2002.

Research output: Contribution to journalArticle

Morgan, T, McDonald, J, Anderson, C, Ismail, M, Miller, F, Mao, R, Madan, A, Barnes, P, Hudgins, L & Manning, M 2002, 'Intracranial hemorrhage in infants and children with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome).', Pediatrics, vol. 109, no. 1.
Morgan, Terry ; McDonald, Jamie ; Anderson, Christina ; Ismail, Magdy ; Miller, Franklin ; Mao, Rong ; Madan, Ashima ; Barnes, Patrick ; Hudgins, Louanne ; Manning, Melanie. / Intracranial hemorrhage in infants and children with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome). In: Pediatrics. 2002 ; Vol. 109, No. 1.
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