Multiple pulmonary arteriovenous malformations

Quaden, C; Ghaye, Benoît; Dondelinger, Robert; Bélaïche, Jacques; Bartsch, Pierre; Cataldo, Didier

doi:10.1016/s0140-6736(02)08833-5

Cited by 4 publications

(2 citation statements)

References 2 publications

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“…Although some episodes of amaurosis fugax were documented in case 3 (but the patient never sought medical attention for such episodes), we did not find a history of ischemic cerebrovascular disease in our series. Other purulent infections have been described in PAVM patients in meninges, liver, spine, and spinal marrow [11,22,23,24,] but such findings were not documented in our series.…”

Section: Discussioncontrasting

confidence: 69%

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Gargiulo

Guastamacchia²,

Resta³

et al. 2006

Respiration

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Hereditary hemorrhagic telangiectasia (HHT) is a systemic angiodysplasia inherited as an autosomal dominant disease. Patients with HHT and pulmonary arteriovenous malformations (PAVMs) are at increased risk for brain abscess (BA), a potentially preventable condition as effective treatment for PAVMs is available. In a center dedicated to HHT, a history of BA was found in 6 out of 128 patients with a definite diagnosis: herewith, their histories are reported focusing on mistakes in the diagnosis and management of the disease. Patients with PAVMs and BA had a higher mean hemoglobin concentration (15.1 g/dl vs. 12.2 g/dl, p < 0.006 by Student’s t test) compared to patients with PAVMs alone. Other clinical features (genetics, bacteriology, types of PAVMs, treatments, outcomes) are also discussed. Prompt diagnosis and screening for visceral involvement is pivotal for HHT patients and their relatives.

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Section: Discussioncontrasting

confidence: 69%

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Gargiulo

Guastamacchia²,

Resta³

et al. 2006

Respiration

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“…Chest radiographs may be abnormal, but changes are frequently non-specific, and the diagnosis may be made incidentally from computed tomography examination particularly in small PAVMs such as found in our case. 3 While pulmonary angiography remains the traditional gold standard, MRA is increasingly used for the noninvasive diagnosis of PAVMs, with contrast echocardiography useful in detecting right to left shunting. 4 Although PAVMs are rare and therefore likely to be under-diagnosed, they are present in 24% of patients with Osler-Weber-Rendu syndrome.…”

Section: Discussionmentioning

confidence: 99%

Multiple brain abscesses in a patient with bilateral pulmonary arteriovenous malformations and immunoglobulin deficiency

Tse

Ooi

et al. 2003

Postgraduate Medical Journal

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A 34 year old Chinese man presented with grand mal seizures complicating multiple brain abscesses caused by mixed oral flora. Because of persistent hypoxaemia contrast spiral thoracic computed tomography was done, which revealed bilateral pulmonary arteriovenous malformations (PAVMs). Concomitant IgA and IgG subclass deficiency was also found. The combination of these two conditions appears to have predisposed this patient to presumably paradoxical septic embolism. The patient’s cerebral condition responded to postoperative antibiotic treatment and he eventually received selective coil embolisation of right lower lobe PAVMs, which relieved his hypoxaemia and dyspnoea.

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Wide-ranging clinical spectrum of paradoxical embolism

Jolobe¹

2021

Postgraduate Medical Journal

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The purpose of this review is to raise the index of suspicion for paradoxical embolism among generalists. The review is based solely on anecdotal reports compiled from EMBASE, MEDLINE, Googlescholar and Pubmed. Search terms were ‘paradoxical embolism’, ‘pulmonary embolism’ and ‘pulmonary arteriovenous malformations’. What emerged was that right-to-left paradoxical embolism could occur with or without concurrent pulmonary embolism, and also with and without proof of the presence of an ‘embolus-in-transit’. Potential sites of single or multiple systemic involvement included the central nervous system, the coronary circulation, renal arterial circulation, splenic circulation, the mesenteric circulation and the limbs. In many cases, the deep veins of the lower limbs were the source of thromboembolism. In other cases, thrombi originated from an atrial septal aneurysm, from a central venous line, from a haemodialysis-related arterio-venous shunt, from a popliteal vein aneurysm, internal jugular vein, superior vena cava, from a pulmonary arteriovenous malformation, from tricuspid valve endocarditis (with and without pulmonary embolism) and from the right atrium, respectively. Stroke was by far the commonest systemic manifestation of paradoxical embolism. Some strokes were attributable to pulmonary arteriovenous malformations with or without coexistence of intracardiac shunts. Clinicians should have a high index of suspicion for paradoxical embolism because of its time-sensitive dimension when it occurs in the context of involvement of the intracranial circulation, coronary circulation, mesenteric circulation, and peripheral limb circulation.

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Multiple pulmonary arteriovenous malformations

Cited by 4 publications

References 2 publications

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Pulmonary Arteriovenous Malformations, Hereditary Hemorrhagic Telangiectasia, and Brain Abscess

Multiple brain abscesses in a patient with bilateral pulmonary arteriovenous malformations and immunoglobulin deficiency

Wide-ranging clinical spectrum of paradoxical embolism

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