HHT and hereditary nosebleeds
Repeated nosebleeds caused by hereditary haemorrhagic telangiectasia (HHT, Osler-Weber-Rendu syndrome), a genetic condition affecting small blood vessels.
HHT is an inherited condition in which small blood vessels form abnormal, fragile connections. Recurrent nosebleeds are the commonest symptom, but HHT can also affect vessels in the lungs, brain and liver, which is why a proper diagnosis and screening through the NHS HHT service matter.
How it presents
- Recurrent nosebleeds, often from childhood, worsening with age
- Small red spots (telangiectasia) on the lips, tongue, fingertips and inside the nose
- A family history; an affected parent has a 50% chance of passing it on
- Tiredness and iron-deficiency anaemia from chronic blood loss
Treatment
There is no cure, but treatment steps up as bleeding gets harder to control: moisturisers and humidification, tranexamic acid, laser ablation of the bleeding vessels, bevacizumab (as drops, injection or systemically), and reconstructive surgery for the most severe cases. Mr Gane has a long-standing clinical and research interest in HHT and its surgical and anaesthetic considerations.
Assessment
Diagnosis uses the Curaçao criteria (nosebleeds, telangiectasia, family history, internal vascular malformations) with genetic testing through the NHS HHT service. Anyone with HHT planning a procedure under general anaesthetic needs specific precautions discussed in advance.
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This page is general information and not a substitute for individual medical advice.