Multidisciplinary screening and treatment of patients with Rendu-Osler-Weber disease

Abstract

Objective. Multidisciplinary information, screening and treatment of patients with Rendu-Osler-Weber disease (ROW). Materials and methods. The Martini Hospital has free consulting hours for ROW patients and their relatives. Information about this hereditary disease is given and after the history a preliminary examination is made. Nail matrix microscopy can assist in reaching the diagnosis. Appointments are arranged for further examinations and/or treatment. A letter is sent to the GP, together with a summary of information concerning ROW. The follow-up is carried out by protocols. Results. Patients understand the need for tests and treatment due to their increased knowledge of ROW. Relatives are often found to have ROW. Early determination of arteriovenous malformations (AVM) is important because embolization of the relatively frequently occurring pulmonary AVM can prevent septic emboli (brain abscesses). Prophylatic antibiotic use following the endocarditis prophylaxis protocol is indicated in ROW. Preventative and repetitive Nd:YAG laser coagulations are necessary to treat epistaxis and if indicated telangiectases in the mouth or on the face. In the case of serious epistaxis, embolization of the feeding vessels supplying the area can offer relief. Conclusion. The multidisciplinary approach of ROW patients expands the patients and the consultants knowledge of the disease. Early diagnosis, treatment and follow-up are easier to achieve.