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Prasad G, Soni L. Anaesthetic challenges and management of a child of blue rubber bleb nevus syndrome (BRBNS) with pulmonary lesions. Indian J Anaesth 2023; 67:239-240. [PMID: 37091439 PMCID: PMC10121099 DOI: 10.4103/ija.ija_117_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 01/15/2023] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
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Alreefi H, AlKhateeb M. Blue rubber bleb nevus syndrome associated with tuberous sclerosis complex and CNS involvement. ACTA ACUST UNITED AC 2021; 26:207-211. [PMID: 33814375 PMCID: PMC8024125 DOI: 10.17712/nsj.2021.2.20200111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/03/2020] [Indexed: 11/20/2022]
Abstract
Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder that is characterized by multiple dome-shaped cutaneous venous malformations on the skin and visceral organs. Typical extra-cutaneous lesions have the appearance of blueish nipple-shaped nodules that can easily compress and refill. We described a rare case of a 23-year-old female with BRBNS and tuberous sclerosis complex (TSC) that presented with central nervous system (CNS) involvement including unprovoked focal impaired awareness seizure. Her BRBNS presents with hemangiomas involving multiple organs in the body including the brain, gastrointestinal (GI) system, and skin. This case highlights the importance of studying and understanding the association between BRBNS and TSC as it may lead to improved understanding
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Affiliation(s)
- Hajar Alreefi
- From the Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mashael AlKhateeb
- From the Department of Neuroscience, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Anwár G, Elma PA, Adib JDS, Ilse MN, Alonso GR, Ciltlaltepelt SL, Alma NS, Elisa VMM, Antonio A. Blue Rubber Bleb Nevus Syndrome With Multiple Cavernoma-Like Lesions on MRI: A Familial Case Report and Literature Review. Front Neurol 2020; 11:176. [PMID: 32318009 PMCID: PMC7154106 DOI: 10.3389/fneur.2020.00176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/24/2020] [Indexed: 12/23/2022] Open
Abstract
Blue rubber bleb nevus syndrome (BRBNS), also called Bean's syndrome, is a rare disease associated with multiple venous malformations in the skin and gastrointestinal (GI) tract. Dermatological lesions, which are the first clinically visible manifestations, appear as skin-colored compressible protuberances or as dark-blue venous nodules, rubbery in consistency. Central nervous system (CNS) manifestations are rare, variable, non-specific, and tend to occur late in the disease, mainly reported as seizures and focal neurological deficits secondary to compression. Most cases occur sporadically, however, an autosomal dominant inheritance pattern has been reported. A 74-year-old male with history of focal epilepsy secondary to possible neurocysticercosis presented at the emergency department due to sudden onset of aphasia, left central facial paralysis, and dysphagia secondary to catastrophic intracerebral hemorrhage. Cerebral MRI showed multiple cerebral cavernous malformations (CCM)-like lesions and, on the general exploration, multiple dark-blue nodules, rubbery in consistency. One week later he died due to complicated pneumonia; a brain autopsy was performed showing multiple vascular malformations. His son had a history of focal epilepsy presumed to be related to neurocysticercosis. He had the same skin lesions and brain MRI pattern. Histological analysis of the skin lesions of the two cases showed venous vascular malformations. A non-systematic review was carried out, in which all case reports of blue nevus syndrome with neurological manifestations in adults were included.
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Affiliation(s)
- García Anwár
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía "Dr. Manuel Velasco Suarez", Mexico City, Mexico
| | - Paredes-Aragón Elma
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía "Dr. Manuel Velasco Suarez", Mexico City, Mexico
| | - Jorge-de Saráchaga Adib
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía "Dr. Manuel Velasco Suarez", Mexico City, Mexico
| | - Meyer-Nava Ilse
- Dermatology Department, Instituto Dermatológico de Jalisco "José Barba Rubio", Guadalajara, Mexico
| | - Gutiérrez-Romero Alonso
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía "Dr. Manuel Velasco Suarez", Mexico City, Mexico
| | - Salinas Lara Ciltlaltepelt
- Departament of Neuropathology, Instituto Nacional de Neurología y Neurocirugía "Dr. Manuel Velasco Suarez", Mexico City, Mexico
| | - Novelo Soto Alma
- Dermatology Department, General Hospital "Dr. Manuel Gea Gonzalez", Mexico City, Mexico
| | | | - Arauz Antonio
- Department of Neurology, Instituto Nacional de Neurología y Neurocirugía "Dr. Manuel Velasco Suarez", Mexico City, Mexico
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Sharma A, Prasad G, Anand R. Blue rubber bleb nevus syndrome – Anaesthetic experience of prolonged bowel surgery in a twelve year old child and review. EGYPTIAN JOURNAL OF ANAESTHESIA 2019. [DOI: 10.1016/j.egja.2014.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ankur Sharma
- Department of Anaesthesiology, All India Institute of Medical Sciences , New Delhi, India
| | - Ganga Prasad
- Department of Anaesthesiology, All India Institute of Medical Sciences , New Delhi, India
| | - Rahul Anand
- Department of Anaesthesiology, All India Institute of Medical Sciences , New Delhi, India
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Khatri D, Gosal JS, Bhaisora KS, Das KK, Srivastava AK, Behari S. Orbital Hemangioma in Bean Syndrome: The Lure of the Red Herring. World Neurosurg 2018; 123:272-280. [PMID: 30576827 DOI: 10.1016/j.wneu.2018.11.257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bean syndrome (BS) is a rare congenital low-flow angiomatosis affecting multiple organ systems. About 200 cases with heterogeneous clinical presentation have been reported worldwide. The exact etiopathology is still not known. Most reported cases have occurred sporadically, although autosomal dominant inheritance has been suggested. BS predominantly presents with characteristic multifocal mucocutaneous lesions and often leads to refractory anemia caused by occult blood loss from the alimentary tract. Apart from the mucocutaneous and gastrointestinal tract involvement, this syndrome may rarely affect the central nervous system in the form of multiple venous anomalies. Patients often approach a dermatologist or gastroenterologist for treatment and this entity is usually less known among neurosurgeons. To the best of our knowledge, only 3 cases of sinus pericranii and 12 cases with orbital hemangioma as a presenting feature in BS have been reported. CASE DESCRIPTION Keeping neurosurgical management of this rare entity in mind, we discuss a case of a young female who presented with congenital naso-orbital swelling with a history of multiple-stage embolization and surgical excision of the orbital mass in her childhood. Now, she presented with recurrent swelling involving the right side of the forehead for cosmetic concerns and was subsequently diagnosed to have BS at 23 years of age. CONCLUSIONS Blue rubber bleb nevus syndrome is a lesser known entity among neurosurgeons that requires a high index of clinical suspicion for diagnosis. Red herrings, such as in our case, must prompt a search for characteristic mucocutaneous lesions and other associated lesions of blue rubber bleb nevus syndrome. A timely diagnosis may improve the quality of life and help avoid life-threatening complications.
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Affiliation(s)
- Deepak Khatri
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Jaskaran Singh Gosal
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Kamlesh Singh Bhaisora
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - Kuntal Kanti Das
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Arun Kumar Srivastava
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Behari
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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6
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Ocampo-Garza J, Salas-Alanís JC, Ponce-Camacho MA, Rosales-Solis GM, Miranda Maldonado I, Elizondo-Riojas G, Villanueva-Nava D, Barbosa-Quintana O, Gonzalez Colunga K, Ocampo-Candiani J. Fatal Outcome from Brain Vascular Lesions in a Neonate with Blue Rubber Bleb Nevus Syndrome. Pediatr Dermatol 2016; 33:e29-31. [PMID: 26608350 DOI: 10.1111/pde.12718] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The most common cause of death in blue rubber bleb nevus syndrome is gastrointestinal bleeding. Here we present a case of central nervous system bleeding that resulted in death.
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Affiliation(s)
- Jorge Ocampo-Garza
- Department of Dermatology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Julio C Salas-Alanís
- Department of Basic Science, Universidad de Monterrey, Monterrey, Mexico.,Department of Dermatology, Universidad de Monterrey, Monterrey, Mexico
| | - Marco A Ponce-Camacho
- Department of Pathology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Gloria M Rosales-Solis
- Department of Pediatrics, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Ivett Miranda Maldonado
- Department of Pathology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Guillermo Elizondo-Riojas
- Department of Radiology and Imaging, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | | | - Oralia Barbosa-Quintana
- Department of Pathology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Karla Gonzalez Colunga
- Department of Pathology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Jorge Ocampo-Candiani
- Department of Dermatology, University Hospital "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
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Abstract
Neurocutaneous disorders are a heterogeneous group of conditions (mainly) affecting the skin [with pigmentary/vascular abnormalities and/or cutaneous tumours] and the central and peripheral nervous system [with congenital abnormalities and/or tumours]. In a number of such disorders, the skin abnormalities can assume a mosaic patterning (usually arranged in archetypical patterns). Alternating segments of affected and unaffected skin or segmentally arranged patterns of abnormal skin often mirror similar phenomena occurring in extra-cutaneous organs/tissues [eg, eye, bone, heart/vessels, lung, kidney and gut]. In some neurocutaneous syndromes the abnormal mosaic patterning involve mainly the skin and the nervous system configuring a (true) mosaic neurocutaneous disorder; or an ordinary trait of a neurocutaneous disorder is sometimes superimposed by a pronounced linear or otherwise segmental involvement; or, lastly, a neurocutaneous disorder can occur solely in a mosaic pattern. Recently, the molecular genetic and cellular bases of an increasing number of neurocutaneous disorders have been unravelled, shedding light on the interplays between common intra- and extra-neuronal signalling pathways encompassing receptor-protein and protein-to-protein cascades (eg, RAS, MAPK, mTOR, PI3K/AKT and GNAQ pathways), which are often responsible of the mosaic distribution of cutaneous and extra-cutaneous features. In this article we will focus on the well known, and less defined mosaic neurocutaneous phenotypes and their related molecular/genetic bases, including the mosaic neurofibromatoses and their related forms (ie, spinal neurofibromatosis and schwannomatosis); Legius syndrome; segmental arrangements in tuberous sclerosis; Sturge-Weber and Klippel-Trenaunay syndromes; microcephaly/megalencephaly-capillary malformation; blue rubber bleb nevus syndrome; Wyburn-Mason syndrome; mixed vascular nevus syndrome; PHACE syndrome; Incontinentia pigmenti; pigmentary mosaicism of the Ito type; neurocutaneous melanosis; cutis tricolor; speckled lentiginous syndrome; epidermal nevus syndromes; Becker's nevus syndrome; phacomatosis pigmentovascularis and pigmentokeratotica; Proteus syndrome; and encephalocraniocutaneous lipomatosis.
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Affiliation(s)
- Martino Ruggieri
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy.
| | - Andrea D Praticò
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy; Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Ballieux F, Boon LM, Vikkula M. Blue bleb rubber nevus syndrome. HANDBOOK OF CLINICAL NEUROLOGY 2015; 132:223-30. [DOI: 10.1016/b978-0-444-62702-5.00016-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Nerva JD, Hallam DK, Ghodke BV. Percutaneous transfacial direct embolization of an intraosseous dural arteriovenous fistula. Neurosurgery 2013; 10 Suppl 1:E178-82. [PMID: 24141481 DOI: 10.1227/neu.0000000000000213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND IMPORTANCE An intraosseous dural arteriovenous fistula (DAVF) is a rare cerebrovascular disease. The fistulous connection occurs within intraosseous diploic or transosseous emissary veins causing dilated intraosseous vascular pouches. To the authors' knowledge, this report describes the first percutaneous transfacial direct embolization of an intraosseous DAVF. CLINICAL PRESENTATION A man in his 50s with blue rubber bleb nevus syndrome presented with headaches, imbalance, decreased visual acuity bilaterally, and left eye proptosis and chemosis. Imaging demonstrated an extensive intraosseous DAVF with dilated intraosseous vascular pouches throughout his cranial base and intraorbital venous congestion. He underwent staged endovascular treatment with the goal to improve his ocular symptoms. Transarterial and transvenous approaches failed to provide adequate access to the intraosseous vascular pouches. A direct, percutaneous transfacial approach was used to access the pouches for embolization with coils and liquid embolic material. Postoperative angiography demonstrated successful embolization of the pouch within the left pterygoid wing, reduced opacification of the intraosseous fistula, and elimination of intraorbital venous congestion. At 9-month follow-up, the patient's headaches had resolved, and his ocular symptomatology had improved. CONCLUSION Endovascular access to an intraosseous DAVF is limited by the size and location of the intraosseous vascular pouches. In this case, a direct transfacial approach under image guidance facilitated access and embolization, which led to an improvement in the patient's symptoms. This technique is a novel approach for DAVF management.
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Affiliation(s)
- John D Nerva
- Departments of *Neurological Surgery, and ‡Radiology, Harborview Medical Center, University of Washington, Seattle, Washington
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Tomelleri G, Cappellari M, Di Matteo A, Zanoni T, Colato C, Bovi P, Moretto G. Blue rubber bleb nevus syndrome with late onset of central nervous system symptomatic involvement. Neurol Sci 2010; 31:501-4. [PMID: 20352269 DOI: 10.1007/s10072-010-0250-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2009] [Accepted: 03/01/2010] [Indexed: 11/26/2022]
Abstract
Blue rubber bleb nevus syndrome is a rare vascular disorder characterized by cavernous angiomas of skin and other organs including the gastrointestinal tract. The central nervous system involvement is seldom reported, and neurological symptoms at onset in adulthood are extremely rare. Here, we describe a case of 82-year-old patient presenting multiple skin haemangiomas for some years, who was admitted for a brain hemorrhage. The MRI demonstrated the presence of multiple cavernous angiomas within the cerebral tissue.
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Affiliation(s)
- Giampaolo Tomelleri
- Unità Operativa Di Neurologia, Azienda Ospedaliera-Universitaria, Verona, Italy.
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11
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Abstract
Blue rubber bleb nevus syndrome is a rare disorder that is characterized by multiple recurrent vascular malformations, such as hemangioma, and these primarily involve the skin and the gastrointestinal tract. It may also involve the brain, liver, lungs, and skeletal muscles. A 14-year-old female visited our hospital with a chief complaint of dizziness; upon examination, we found multiple recurrent hemangiomas on the skin and gastrointestinal tract. We were able to diagnose her as suffering from blue rubber bleb nevus syndrome and we treated her with methylprednisolone (2 mg/kg/day for 1 month and 1 mg/kg/day for additional 3 months). We report on this case along with a review of the literature.
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Affiliation(s)
- Seung Hwan Shin
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
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12
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Tzoufi MS, Sixlimiri P, Nakou I, Argyropoulou MI, Stefanidis CJ, Siamopoulou-Mavridou A. Blue rubber bleb nevus syndrome with simultaneous neurological and skeletal involvement. Eur J Pediatr 2008; 167:897-901. [PMID: 17934757 DOI: 10.1007/s00431-007-0615-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Accepted: 09/19/2007] [Indexed: 01/10/2023]
Abstract
Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder characterized by venous malformations usually affecting the skin and the gastrointestinal tract. These skin haemangiomas are present at birth and deteriorate as the body grows, causing primarily cosmetic problems. The haemangiomas of the gastrointestinal tract may appear later in life and may bleed, causing chronic anaemia, or may present with severe complications such as rupture, intestinal torsion, and intussusception. Other organs may also be involved. This article describes a 13-year-old boy with multiple haemangiomas of the skin, the mucous membranes, and the gastrointestinal tract, which caused anaemia and ileoileic intussusception. In this patient, the nervous system was significantly affected with a haemangioma of the left occipital lobe, with complications of stroke. He also had multiple paravertebral heamangiomas, which caused pressure signs and symptoms. This boy suffered from complex partial and generalized seizures and cerebral palsy. Multiple skeletal anomalies were also present from birth. In the relevant literature, this is the first case of BRBNS with simultaneous neurological and skeletal involvement. Such cases should be recognized early, as they can lead to serious multiple health problems and handicaps.
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Affiliation(s)
- Meropi S Tzoufi
- Child Health Department, Medical School, University of Ioannina, 45110, Ioannina, Greece.
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Sedat J, Chau Y, Popolo M, Lonjon M. Giant intracerebral telangiectasia in a case of blue rubber-bleb nevus syndrome. Neuroradiol J 2008; 21:327-30. [PMID: 24256901 DOI: 10.1177/197140090802100306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Accepted: 03/28/2008] [Indexed: 11/15/2022] Open
Abstract
Blue rubber-bleb nevus syndrome is a rare condition that consists of multiple venous malformations involving several organ systems, mainly the skin and gastrointestinal tract. Involvement of the central nervous system is particularly rare. We describe a patient with a huge intracerebral telengiectasia revealed by a progressive neurological deficit.
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Affiliation(s)
- J Sedat
- Neuroradiology Department, Hôpital St Roch, CHU NICE; Nice, France -
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14
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Abstract
BACKGROUND Blue rubber bleb nevus syndrome (BRBNS) is characterized by distinctive vascular malformations of skin and the gastrointestinal tract, often leading to chronic anemia and intestinal bleeding. It usually presents right after birth or during early infancy. Though the disease is inherent, its occurrence is sporadic. Thus it is usually not timely diagnosed. We analyzed the clinical characteristics and treatment of this disorder in order to improve the diagnosis and treatment. METHODS Three patients with BRBNS treated at our hospital during 2002-2003 and 39 patients from the literature reported during 1965-2003 were reviewed in terms of the diagnosis and treatment. BRBNS may be diagnosed as cutaneous cavernous hemangioma associated with the same lesion of the gastrointestinal tract and other organs. RESULTS Our 3 patients suffered from cutaneous angioma and gastrointestinal hemangioma. In 39 patients reported in the literature, cutaneous angioma was observed in all of them, and gastrointestinal hemangioma in 31. Additionally, the lesions were also found in other organs such as the brain (7 patients), joint (2), liver (2), eye (1), kidney (1) and spleen (1). Cutaneous angioma was located on the surface of the skin, including body (93%), limbs (86%), hip (36%) and face (26%). Gastrointestinal hemangioma was more common in the small intestine (100%) than in the colon (74%) and stomach (26%). When the joint was involved by hemangioma, pathologic fracture or overgrowth of bone needed traction and amputation (1 patient respectively). For significant gastrointestinal bleeding, endoscopic techniques (8 patients), surgical excision (5), or both (1) were performed. Recurrent bleeding was successfully treated by endoscopic laser combined with steroid or interferon in one patient. CONCLUSIONS BRBNS in children presents atypical symptom and systemic complications. It should be dealt with seriously if gastrointestinal bleeding or orthopedic complication occurs. Treatment includes conservative, endoscopic and surgical options. Its recurrence with new angioma in the gastrointestinal tract needs laser-steroid therapy.
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Affiliation(s)
- Tom den Heijer
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.
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Kishikawa H, Okada Y, Kawahara T, Saito K, Tanaka Y. A case of blue rubber bleb nevus syndrome treated by etidronate. J Bone Miner Metab 2007; 25:138-41. [PMID: 17323184 DOI: 10.1007/s00774-006-0740-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Accepted: 11/09/2006] [Indexed: 01/10/2023]
Affiliation(s)
- Hirofumi Kishikawa
- First Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
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Holland KE, Galbraith SS, Drolet BA. Neonatal Violaceous Skin Lesions: Expanding the Differential of the “Blueberry Muffin Baby”. ACTA ACUST UNITED AC 2005; 21:153-92. [PMID: 16350442 DOI: 10.1016/j.yadr.2005.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Kristen E Holland
- Clinical Instructor/Pediatric Dermatology Fellow, Medical College of Wisconsin, Department of Dermatology, Milwaukee, Wisconsin, USA
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Chung JI, Alvarez H, Lasjaunias P. Multifocal cerebral venous malformations and associated developmental venous anomalies in a case of blue rubber bleb nevus syndrome. Interv Neuroradiol 2004; 9:169-76. [PMID: 20591267 DOI: 10.1177/159101990300900206] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2003] [Accepted: 04/04/2003] [Indexed: 11/17/2022] Open
Abstract
SUMMARY We report a sporadic case of probable BRBN (blue rubber bleb nevus syndrome) with multiple CNS (central nervous system) involvement. These features consisted of multiple VMs (venous malformations) and DVAs (developmental venous anomalies) in supratentorial brain, cerebellum, and diencephalon. Since its first description by Bean, there have been many cases of BRBN manifesting with gastrointestinal bleeding with or without associated hemorrhage. Cases with CNS involvement were rarely reported and many of the descriptions were confusing with different terminologies used to describe them such as capillary venous malformation, hemangiomas, and vascular malformations. The lesions illustrated are venous malformations similar to our case. The association of DVA was recognized in some cases; they are likely to be underestimated when revisiting the published case illustrations.Although our case is sporadic, the link with HHT1 is unlikely despite the involvement of the same chromosome (Ch 9).
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Affiliation(s)
- J I Chung
- Department of Radiology, Inha University Hospital, Incheon; South Korea
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Apak H, Celkan T, Ozkan A, Yildiz I, Aydemir EH, Ozdil S, Kuruoglu S. Blue rubber bleb nevus syndrome associated with consumption coagulopathy: treatment with interferon. Dermatology 2004; 208:345-8. [PMID: 15178920 DOI: 10.1159/000077846] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2002] [Accepted: 01/08/2004] [Indexed: 11/19/2022] Open
Abstract
The blue rubber bleb nevus syndrome (BRBNS) is a rare vascular malformation syndrome with cutaneous and visceral lesions frequently associated with serious, even fatal bleeding. No systemic therapy is currently available. We report here a case with disseminated skin and gastrointestinal venous malformations and findings of disseminated intravascular coagulation that was treated with interferon beta. The disseminated intravascular coagulation manifestations were cleared with the treatment. The regression of the coagulopathy in our patient led us to think that the use of interferon beta in BRBNS might be beneficial.
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Affiliation(s)
- H Apak
- Pediatric Hematology-Oncology, Cerrahpasa Medical School, Istanbul Medical School, Istanbul University, Istanbul, Turkey.
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Abstract
This article outlines the clinical, central nervous system, and neuropathologic features,pathogenesis, genetics, molecular biology, and neuroimaging characteristics of the rare vascular phakomatoses, melanophakomatoses, and organoid phakomatoses.
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Affiliation(s)
- Simon Edelstein
- Department of Radiology, MIA Group Limited Box Hill Hospital, Melbourne, Australia
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Gabikian P, Clatterbuck RE, Gailloud P, Rigamonti D. Developmental venous anomalies and sinus pericranii in the blue rubber-bleb nevus syndrome. Case report. J Neurosurg 2003; 99:409-11. [PMID: 12924718 DOI: 10.3171/jns.2003.99.2.0409] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Blue rubber-bleb nevus syndrome (BRBNS) is a developmental disorder that originally was identified by the presence of distinctive cutaneous and gastrointestinal hemangiomas. More recently it has been recognized that the number of affected organs is larger and that BRBNS includes central nervous system vascular malformations. A 52-year-old woman in whom intracranial vascular malformations had been diagnosed earlier presented for evaluation. At birth, several blue nevi had been noted on her tongue, lips, and neck. Cerebral angiography demonstrated an extensive network of developmental venous anomalies and a left anterior sinus pericranii. The literature on BRBNS and developmental venous anomalies is reviewed.
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Affiliation(s)
- Patrik Gabikian
- Department of Neurological Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-7713, USA
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Villalain L, Junquera LM, Díaz M, González M. Blue rubber bleb nevus syndrome: immunohistochemical study. Ann Otol Rhinol Laryngol 2003; 112:647-50. [PMID: 12903687 DOI: 10.1177/000348940311200713] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Blue rubber bleb nevus is a rare entity consisting of distinctive angiomas in the skin and gastrointestinal tract, leading to occult or profound gastrointestinal bleeding and chronic anemia. The efficacy has been documented of systemic treatment with corticoids, interferon, vincristine, and, more recently, subcutaneous octreotide in the presence of active lesion proliferation or disseminated intravascular coagulation. A case of blue rubber bleb nevus syndrome with oral hemangiomas in a 24-year-old woman is reported. The surgical specimens were subjected to immunohistochemical study, which showed all of the hemangiomas to be in an inactive phase.
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Affiliation(s)
- Lucas Villalain
- Department of Maxillofacial Surgery, University of Oviedo, Asturias Central Hospital, Oviedo, Spain
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Eirís-Puñal J, Picón-Cotos M, Viso-Lorenzo A, Castro-Gago M. Epileptic disorder as the first neurologic manifestation of blue rubber bleb nevus syndrome. J Child Neurol 2002; 17:219-22. [PMID: 12026239 DOI: 10.1177/088307380201700313] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Blue rubber bleb nevus syndrome is an uncommon neurocutaneous disorder characterized by distinctive vascular malformations on the body surface. Vascular malformations of internal organs (typically the gastrointestinal tract) are also frequently present. However, malformations of the central nervous system have only rarely been described. We report a case of blue rubber bleb nevus syndrome in a 5-month-old boy with cutaneous manifestations characteristic of this process present from birth and multiple cerebral angiomas detected by magnetic resonance imaging. At age 1(1/2) months, the patient showed myoclonic seizures and complex partial seizures that were refractory to various antiepileptic regimens. At age 5 months, electroencephalograms (EEGs) showed continuous generalized slow spike-waves, predominantly in the right temporal region; however, EEGs normalized after induction of coma with intravenous midazolam. At age 13 months, the patient suffered from occasional seizures and slightly retarded psychomotor development. Epilepsy is rare in this syndrome but as in other neurocutaneous syndromes (e.g., Sturge-Weber syndrome) can compromise psychomotor development; thus, every effort should be made to control seizures.
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Affiliation(s)
- Jesús Eirís-Puñal
- Servicio de Neuropediatría, Hospital Clínico-Universitario, Santiago de Compostela, Spain.
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