ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Epistaxis Severity in Pediatric HHT Patients Is Typically Mild

by Amy E. Hamaker • July 8, 2018

  • Tweet
  • Email
Print-Friendly Version

How do epistaxis onset and severity present in pediatric hereditary hemorrhagic telangiectasia (HHT) patients in terms of age of onset within genetic subtypes?

Bottom line
Epistaxis may present early in HHT, but is typically mild in the pediatric period and is slightly worse in patients with HHT1.

You Might Also Like

No related posts.

Explore This Issue
July 2018

Background: HHT is an autosomal dominant disorder of vascular formation that has multiple genetic subtypes, with HHT type 1 and HHT type 2 making up the majority of cases. HHT-associated vascular lesions include telangiectases and arteriovenous malformations (AVMs), and epistaxis is the most common HHT symptom. Reports of epistaxis onset in childhood have largely relied on adult patient recall, and there are no reports to date of epistaxis severity in the pediatric HHT population. Early HHT detection allows for solid organ screening for AVMs and treatment to avoid potentially catastrophic complications.

Study design: Retrospective cohort chart review of 69 patients aged 0 to 18 years with a clinical or genetic HHT diagnosis who were evaluated at a tertiary multidisciplinary HHT clinic from January 2010 to June 2016.

Setting: University of Utah HHT Center, Salt Lake City.

Synopsis: Sixty patients had HHT confirmed by genetic testing, and nine (from families with known mutations) met published clinical diagnostic criteria alone. All patients had a family history of HHT. Over 90% of patients had either HHT2 or HHT1. The mean patient age at evaluation was 9 years, and the median epistaxis onset age was 5 years. Patients with HHT1 had a younger median epistaxis onset age at 3 years (versus 5 years in HHT2). Ten subjects had not yet developed epistaxis. The majority of patients with epistaxis experienced mild bleeding; none experienced severe nosebleeds. Anemia was noted in only two patients, and no blood transfusion treatment were required. Four patients sought medical attention for their nosebleeds. There was no difference in the number of clinical diagnostic criteria in patients with HHT1 versus HHT2, but the slightly higher HHT1 score was statistically significant after adjusting for age and sex. Median epistaxis severity scores were higher in HHT1, while epistaxis frequency and duration tended to be lower in HHT2. Limitations included a lack of routine rhinoscopy during evaluation and ascertainment bias due to HHT specialty clinic evaluation.

Citation: Gonzalez CD, McDonald J, Stevenson DA, et al. Epistaxis in children and adolescents with hereditary hemorrhagic telangiectasia. Laryngoscope. November 24, 2017. Doi: 10.1002/lary.27015.

Filed Under: Literature Reviews, Pediatric Tagged With: epistaxis, HHT, pediatric patients, pediatricsIssue: July 2018

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Complications for When Physicians Change a Maiden Name
    • Neurogenic Cough Is Often a Diagnosis of Exclusion
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • FDA Approves First Treatment for Eosinophilic Esophagitis
    • Clinical Best Practices: Otolaryngologists Tackle Questions
    • Otolaryngologist Shares Experience with Image Manipulation in Research and How to Prevent It
    • Methodology to Study Care Barriers for Head and Neck Cancer Patients in Low- and Middle-Income Countries Yields Insights
    • Spreader Graft Placement Found Comparable in Functional Outcome in Patients with Nasal Obstruction

Polls

Do you think most image manipulation in studies is done accidentally or on purpose?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2022 The Triological Society. All Rights Reserved.
ISSN 1559-4939