Hereditary Hemorrhagic Telangiectasia and Factor VIII Deficiency

Until the early 20th century, hereditary hemorrhagic telangiectasia (HHT) was confused with hemophilia. The distinction between the two was clarified by Rendu, Osier, Weber and others, and since then these two disorders have been regarded as separate clinical entities.^1-3 The possibility of their chance coexistence in the same patient was suggested by Hanes in 1909.⁴ In 1968, Quick alluded to a patient with both HHT and mild hemophilia A (antihemophilic globulin deficiency, factor VIII deficiency) and mentioned the patient's severe gastrointestinal tract bleeding, but gave no details.⁵ We believe ours to be the first report of hereditary hemorrhagic telangiectasia occurring in a patient with proven factor VIII deficiency.

Patient Summary  A 78-year-old white man, a retired railroad foreman, in the past 18 years has had 56 admissions to the Birmingham and Montgomery (Ala) Veterans Administration hospitals for various hemorrhagic episodes. He related a history of prolonged bleeding