Abstract
Ever since the WHO's declaration of the SARS-CoV-2 pandemic, the medical literature has been focusing upon the patterns of association of SARS-CoV-2 with different diseases. Patients with Osler-Weber-Rendu Syndrome, also known as, Hereditary hemorrhagic telangiectasia (HHT), presents with recurrent epistaxis, nostril manipulations, incidental detection of multiple AVMs (Arterio-Venous Malformations), and telangiectasias over mucocutaneous tissues and internal organs. In addition, these AVMs are prone to bleed or act as a nidus for thrombus formation apart from other serious complications like chronic hypoxemia, anemia, pulmonary artery hypertension, heart failure, and cerebrovascular disease accidents. Here, we provide a case report of such a patient who was diagnosed with HHT as per 'Curaçao criteria'; having a history of multiple episodes of epistaxis, radiological evidence of AVMs over left calf, pulmonary and hepatic region, multiple telangiectasias in the splenic region and uterine vascular malformations. Upon acquiring severe COVID-19 infection, the patient developed complications like anemia, pulmonary artery hypertension, sepsis, acute kidney injury, and post COVID-19 persistence of type1 respiratory failure. Moreover, the risk-benefit ratio of anticoagulation therapy in such patients with COVID-19 infection is tricky and challenging; however, our patient was prophylactically anti-coagulated with enoxaparin for 12 days with an uneventful outcome.
Keywords: Osler-Weber-Rendu Syndrome, Hereditary hemorrhagic telangiectasia, HHT, Prophylactic Anticoagulation, Covid-19, SARS-CoV-2.
Hereditary hemorrhagic telangiectasia presenting as a recurrent epistaxis in an adolescent: A case report
