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CRST Syndrome With Gastrointestinal Bleeding. Presented by Dr. Robert T. Binford, Jr
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History.—
This 54-year-old white woman was admitted with tarry stools and hematemesis to the New York Hospital on April 10, 1967. Her present illness began approximately 15 years ago with Raynaud's phenomenon involving both hands and feet. Ten years prior to admission she was told of telangiectasia of the face, and a diagnosis of Rendu-Osler-Weber disease was made in spite of a negative family history. Subcutaneous calcifications over the knees and elbows were first noted at that time. During the next decade, minor hardening of the skin of the fingers was noted with some restriction of range of motion. In addition, chronic bronchitis has been present for years.Her bleeding diathesis began two years ago with severe epistaxis requiring nasal packing. For the past 18 months, numerous episodes of gastrointestinal (GI) hemorrhage have occurred and