Thalidomide for hereditary haemorrhagic telangiectasia

Recurrent and severe epistaxis is the most common presentation of hereditary haemorrhagic telangiectasia, a rare autosomal dominant bleeding disorder characterised by mucocutaneous telangectasias and arteriovenous malformations.1,2 The onset of this severe symptom can lead to anaemia requiring frequent intravenous infusions of iron and, often, transfusion of red blood cells. Several approaches have been attempted to manage the nosebleeds of patients with hereditary haemorrhagic telangiectasia, including compression techniques, bilateral embolisation, and surgical arterial ligation, in addition to other, less commonly applied, treatments, such as laser therapy, sclerosing agents, electrocauterisation, and septodermoplasty.