Clinical Case of Rendu–Osler Syndrome: The Role of Pharmaceutical Care in Optimizing Pharmacotherapy
Abstract
Introduction. Rendu-Osler syndrome, also known as hereditary hemorrhagic telangiectasia, is an orphan genetic disorder characterized by multisystem vascular involvement and recurrent bleeding, most commonly epistaxis. Frequent nosebleeds can lead to chronic iron-deficiency anemia and significantly impair patients' quality of life.
Aim. This study aimed to substantiate the role of pharmaceutical care in ensuring rational and safe use of medications based on a clinical case of Rendu-Osler syndrome.
Materials and Methods. A retrospective analysis of a patient's medical records for Rendu-Osler syndrome for the period 2022-2025 was conducted using the case method. A clinical and pharmaceutical analysis of the prescribed pharmacotherapy was conducted, along with an assessment of potential drug interactions using the DrugBank Online database and a retrospective review of literature sources in PubMed and Cochrane Library.
Results. The patient presented with recurrent episodes of epistaxis, anemic syndrome, and the need for interventional treatment. The use of tranexamic acid contributed to a reduction in the intensity and frequency of nosebleeds. The clinical and pharmaceutical analysis helped identify potential risks of drug interactions and formulate recommendations to improve the safety of pharmacotherapy, including monitoring of coagulation parameters and iron status with the possibility of iron deficiency correction.
Conclusions. The presented clinical case demonstrates the importance of a comprehensive approach to managing patients with Rendu-Osler syndrome. Pharmaceutical care, which encompasses clinical and pharmaceutical analysis of pharmacotherapy, safety monitoring, and patient education, is an essential tool for optimizing treatment and improving clinical outcomes.
References
Dunphy L, Talwar A, Patel N, Evans A. Hereditary haemorrhagic telangiectasia and pulmonary arteriovenous malformations. BMJ Case Rep. 2021;14(1):e238385. https://doi.org/10.1136/bcr-2020-238385
Floria M, Năfureanu ED, Iov DE, Sîrbu O, Dranga M, Ouatu A, Tănase DM, Bărboi OB, Drug VL, Cobzeanu MD. Hereditary Hemorrhagic Telangiectasia and Arterio-Venous Malformations—From Diagnosis to Therapeutic Challenges. J Clin Med. 2022;11(9):2634. https://doi.org/10.3390/jcm11092634
McDonald J, Wooderchak-Donahue W, VanSant Webb C, Whitehead K, Stevenson DA, Bayrak-Toydemir P. Hereditary hemorrhagic telangiectasia: genetics and molecular diagnostics. Genetics in Medicine. 2015;17(7):515-522. https://doi.org/10.3389/fgene.2015.00001
Faughnan ME, Palda VA, Garcia-Tsao G, et al. International guidelines for the diagnosis and management of hereditary hemorrhagic telangiectasia. Journal of Medical Genetics. 2011;48(2):73-87. https://jmg.bmj.com/content/48/2/73.long
Dupuis O, Delagrange L, & Dupuis-Girod, S. Hereditary haemorrhagic telangiectasia and pregnancy: a review of the literature. Orphanet J Rare Dis. 2020;15(5). https://doi.org/10.1186/s13023-019-1286-z
Aliuș RO, Pulpă RO, Voiosu C, Ioniță IG, Rusescu A, Hainăroșie R, Zainea V. Rendu-Osler disease, a cause of recurrent epistaxis: a case report. J Med Life. 2025;18(4):397-401. https://doi.org/10.25122/jml-2025-0070
Романенко Р, Лазюк С, Тарасенко М, Довгич С. Випадок носової кровотечі при синдромі ослера-вебера-ренду. USMYJ. 2025;54(2):10-6. https://doi.org/10.32345/USMYJ.2(154).2025.10-16
Franke M, Franke J, Saager C, Barthel S, Riemann R, Mueckner K. Not All Embolizations Are Created Equally in the Management of Posterior Epistaxis: Discussion of Safety Measures Avoiding Neurological Complications. Radiol Res Pract 2020:1-8. https://doi.org/10.1155/2020/5710313
Chitsuthipakorn W, Hoang MP, Kanjanawasee D, Seresirikachorn K, Snidvongs K. Treatments of Epistaxis in Hereditary Hemorrhagic Telangiectasia: Systematic Review and Network Meta-Analysis. Curr Allergy Asthma Rep. 2023;23:689-701 https://doi.org/10.1007/s11882-023-01116-8
Faughnan ME, Mager JJ, Hetts SW, Palda VA, Lang-Robertson K, Buscarini E, et al. Second International Guidelines for the Diagnosis and Management of Hereditary Hemorrhagic Telangiectasia. Ann Intern Med. 2020;173(12):989-1001. https://doi.org/10.7326/M20-1443
Міністерство охорони здоров’я України. Стандарт медичної допомоги «Носова кровотеча»: наказ МОЗ України від 15.12.2022 № 2273 [Internet]. Київ: МОЗ України; 2022. Доступно: https://www.dec.gov.ua/wp-content/uploads/2022/12/2022_12_15_2273smd-nk.pdf
Kritharis A, Al-Samkari H, Kuter DJ. Hereditary hemorrhagic telangiectasia: diagnosis and management from the hematologist’s perspective. Haematologica. 2018;103(9):1433-43. https://doi.org/10.3324/haematol.2018.193003
Żyła D, Zych K, Krawczyk M, Nowakowska J. Hereditary Hemorrhagic Telangiectasia—Current Therapies and Future Prospects. J Vasc Dis. 2025;4(4):43. https://doi.org/10.3390/jvd4040043

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