As this patient with HHT grows older, her bleeding tendency will likely become progressively more difficult to manage.

As this patient with HHT grows older, her bleeding tendency will likely become progressively more difficult to manage. If she were premenopausal, oral contraceptives would be an option, but in this patient, she may respond instead to tamoxifen. She must also be carefully followed for any symptoms of arteriovenous malformations, which need to be immediately treated by catheter-directed embolization.

The management of this patient's iron deficiency will also become a significant problem. She should receive maximum oral iron therapy in combination with repeated doses of parenteral iron (see Chapter S). lf this regimen fails to correct her anemia, she will eventually require increasingly frequent red cell transfusions to maintain a stable hematocrit around 30%.

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Based on smear morphology and the red blood cell indices (mean cell volume [MCV], mean cell hemoglobin [MCH], mean corpuscular hemoglobin concentration [MCHC]), the patient has a severe microcytic, hypochromic anemia most likely caused by iron deficiency (see Chapter 5).

Based on smear morphology and the red blood cell indices (mean cell volume [MCV], mean cell hemoglobin [MCH], mean corpuscular hemoglobin concentration [MCHC]), the patient has a severe microcytic, hypochromic….

Given the diagnosis of HHT, how should this patient be managed?

The patient's history and physical examination (telangiectasia involving the lips, tongue, and palms) are consistent with a diagnosis of hereditary hemorrhagic telangiectasia (HHT). Three diagnostic criteria are met: multiple telangiectases,….

What additional workup/tests are indicated?

A 56-year-old man presents with a complaint of rash and bleeding from the nose and mouth for the past week. His history is notable for non-Hodgkin lymphoma (NHL;follicular center cell)….