How is epistaxis characterized in patients with Osler-Weber-Rendu disease (OWRD) (hereditary hemorrhagic telangiectasia [HHT])?

Updated: Oct 06, 2020
  • Author: Klaus-Dieter Lessnau, MD, FCCP; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Nosebleeds may occur as often as every day or as infrequently as once a month. Patients with epistaxis usually present before the second decade of life. Blood transfusions are required in 10-30% of patients, and as many as 50% of patients require surgical treatment.

At present, there is no universally accepted method of measuring epistaxis severity. Rebeiz developed a classification that stratified epistaxis as follows [42] :

  • Mild - A few episodes per week without transfusion requirement
  • Moderate - One or two episodes per day, with fewer than 10 transfusions required in the patient’s lifetime
  • Severe - Daily episodes lasting longer than 30 minutes, with more than 10 transfusions required in the patient’s lifetime

More than 900 respondents from 21 countries are currently participating in a study intended to create an epistaxis severity score for use in patients with OWRD. [43]


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