The Medical Consumer's Advocate
Hereditary nose bleeds
Q:
I was
told that epistaxis is hereditary. Do you know if
this is true? Could a medication such as phentermine
affect this? I am really interested in finding out if
epistaxis is hereditary and if there are any journals or
articles written on this. Any information would be
appreciated.
A: Epistaxis is
usually NOT hereditary, but there are a few exceptions to
this general rule. One is a condition known as
hereditary telangectasia, in which the affected
individual has multiple abnormal vascular formations which
are small but troublesome, particularly the ones
that occur in the nose. These bleed readily.
Individuals with this condition may have nose
bleeds severe enough to require transfusion.
There are also several hereditary blood clotting disorders; hemophilia is only the
best known example of this. Individuals with
such disorders tend to have bad nose
bleeds as well as other evidence of a
systemic blood clotting disorder (easy bruising,
exceptionally heavy menstruation, painful bleeding
into the joints, etc.)
I assume you are asking this
question because you know someone, say a father and son, who
both have frequent nose bleeds. What you should realize is
that the two affected individuals share more than just their
genes. They will often share the same environment (which may
be cold and dry or hot and dry-- both combinations promote nose bleeds)
and the same bad habits (such as nose picking). Also, bloody noses are a
common enough problem that one might see a father-and-son bloody duo purely
by chance. Thus, not all such associations are genetic.
Regarding hereditary telangectasia,
most ENTs are familiar with this problem and can examine the
individual with this in mind, provided the ENT suspects the
diagnosis.