About Hereditary Hemorrhagic Telangiectasia
Hereditary Hemorrhagic Telangiectasia results from mutations in genes regulating blood vessel integrity, most commonly endoglin (ENG gene, HHT1) or activin receptor-like kinase 1 (ALK1, HHT2 gene), and less commonly other genes.
These mutations impair transforming growth factor-beta (TGF-β) signaling, crucial for proper blood vessel development and maintenance. The hallmark features include telangiectasias (small dilated blood vessels in skin and mucous membranes) and arteriovenous malformations (direct connections between arteries and veins lacking intervening capillaries). Recurrent nosebleeds occur in 90% of patients by age 30 and can be severe and frequent, leading to iron-deficiency anemia. Telangiectasias on lips, oral mucosa, and fingers are common diagnostic findings.
Gastrointestinal bleeding occurs in 10-30% of patients from intestinal telangiectasias. Pulmonary arteriovenous malformations occur in 5-35% of patients, potentially causing paradoxical embolism (blood clots crossing to arterial circulation) and stroke. Hepatic arteriovenous malformations occur in 5-30% and can cause liver cirrhosis. Cerebral malformations carry risk of hemorrhagic stroke.
Common Symptoms of Hereditary Hemorrhagic Telangiectasia
Recognizing the signs of Hereditary Hemorrhagic Telangiectasia early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.
- Frequent and recurrent nosebleeds (epistaxis)
- Mucocutaneous telangiectasias (small red spots on lips, fingers, mucous membranes)
- Gastrointestinal bleeding with anemia and bloody stools
- Shortness of breath from pulmonary arteriovenous malformations
- Headaches or neurologic symptoms from cerebral malformations
- Hepatic complications from hepatic arteriovenous malformations
Who Hereditary Hemorrhagic Telangiectasia Affects
Hereditary Hemorrhagic Telangiectasia can manifest at any age from childhood onward, with most cases recognized in childhood to early adulthood. It affects males and females equally. The disease occurs across all racial and ethnic groups.
It follows an autosomal dominant inheritance pattern, with 75-80% of affected individuals having an affected parent. About 20% represent de novo mutations. Penetrance is nearly complete, though severity varies considerably even within families.
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Trusted Hereditary Hemorrhagic Telangiectasia Resources
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