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Topics:
Pediatric Hematology/Oncology • Hematology • Pediatric Hematology • Benign Hematology • HHT • ENT
How would you manage HHT with ongoing epistaxis despite IV bevacizumab, with a history of superficial thrombosis?
Has undergone cauterization with ENT, also topical/intranasal bevacizumab, and rose geranium oil. IV bevacizumab was initially helpful, but now with breakthrough epistaxis. Would you consider pomalidomide despite the history of thrombosis? Superficial thrombosis (no DVT) occurred in setting of TXA use, which was discontinued and thrombosis managed conservatively.
Answer from: at Community Practice
This is a complex situation with a complex answer, and the patient would likely benefit from establishing care at one of the 30 HHT centers of excellence for a more thorough evaluation. If the patient mentioned has only had cautery, we would consider them seeing an ENT at an HHT center of excellence...
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