肺動静脈瘻を伴つたOsler氏病

OSLER'S DISEASE WITH BILATERAI PULMONARY ARTERIO-VENOUS FISTULAE

　I．はじめに

　反復性鼻出血を主訴とする遺伝性出血性末梢血管拡張症（Osler病）の報告は，近年わが科領域においても，次第に増加の傾向がみられ^1）2），鼻出血症例中に少なからず本症がひそむ可能性も問題にされるようになつた^3）4）。

　われわれは家族性に発現した本症を経験し，その発端者においては肺動静脈瘻，肝内血管拡張をも同時に伴つていたので報告する。

　A case of hereditary hemorrhagic teleangiectasis in a woman, aged 37, is reported. The patient complained of a repeated epistaxis for the period 2 months. The treatment by means of electrocoagulation was effective for only a week.

　The chest x-ray examination revealed an abnormal shadow in the left lower lobe.

　Further examination revealed teleangiectasis on the nasal mucous membrane, lips and tongue. The pulmonary and celiac angiographies revealed bilateral pulmonary arteriovenous fistulas and multiple angiostatic abnormalities in the liver. Operative treatment was impossible.

　The patient was treated by administration of anticoagulant drugs and local applications of electrocoagulations.

　A recent examination showed the patient remarkably improved in her general condition and a stop in the nasal bleeding.