Blue rubber bleb nevus syndrome physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Blue rubber bleb nevus syndrome}} | |||
{{CMG}} ; {{AE}} {{VKG}} | |||
== Overview == | == Overview == | ||
The presence of [[skin lesions]] on [[physical examination]] is highly suggestive of | The presence of [[skin lesions]] on [[physical examination]] is highly suggestive of blue rubber bleb nevus syndrome. | ||
== Physical Examination == | == Physical Examination == | ||
Physical examination of patients with | Physical examination of patients with blue rubber bleb nevus syndrome is usually remarkable for [[cutaneous]] manifestations.<ref name="pmid25493043">{{cite journal |vauthors=Jin XL, Wang ZH, Xiao XB, Huang LS, Zhao XY |title=Blue rubber bleb nevus syndrome: a case report and literature review |journal=World J. Gastroenterol. |volume=20 |issue=45 |pages=17254–9 |date=December 2014 |pmid=25493043 |pmc=4258599 |doi=10.3748/wjg.v20.i45.17254 |url=}}</ref> | ||
=== Appearance of the Patient === | === Appearance of the Patient === | ||
| Line 11: | Line 13: | ||
=== Vital Signs === | === Vital Signs === | ||
* [[Tachycardia]] with regular pulse | * [[Tachycardia]] with regular pulse. | ||
=== Skin === | === Skin === | ||
* [[Skin lesions]] in patients with | * [[Skin lesions]] in patients with blue rubber bleb nevus syndrome classified into:<ref name="pmid22891566">{{cite journal |vauthors=Akutko K, Krzesiek E, Pytrus T, Iwańczak B |title=[Blue rubber bleb naevus syndrome--a rare cause of bleeding from the gastrointestinal tract--case report] |language=Polish |journal=Pol. Merkur. Lekarski |volume=32 |issue=192 |pages=394–6 |date=June 2012 |pmid=22891566 |doi= |url=}}</ref> | ||
** [[Cutaneous]] and | ** [[Cutaneous]] and | ||
** Extracutaneous manifestations | ** Extracutaneous manifestations | ||
=== Cutaneous manifestations === | === Cutaneous manifestations === | ||
* The [[skin lesions]] are usually multifocal [[venous malformations]] which are dark blue in colour | * The [[skin lesions]] are usually multifocal [[venous malformations]] which are dark blue in colour<ref name="pmid254930432">{{cite journal |vauthors=Jin XL, Wang ZH, Xiao XB, Huang LS, Zhao XY |title=Blue rubber bleb nevus syndrome: a case report and literature review |journal=World J. Gastroenterol. |volume=20 |issue=45 |pages=17254–9 |date=December 2014 |pmid=25493043 |pmc=4258599 |doi=10.3748/wjg.v20.i45.17254 |url=}}</ref><ref name="pmid295372052">{{cite journal |vauthors=Gawlikowska-Sroka A, Glura B, Mokrzycka M, Ociepa T |title=[Bean Syndrome (blue rubber bleb nevus syndrome)] |language=Polish |journal=Pomeranian J Life Sci |volume=62 |issue=2 |pages=5–7 |date=2016 |pmid=29537205 |doi= |url=}}</ref> | ||
* These [[lesions]] vary from millimeters to centimeters in size and diameter | * These [[lesions]] vary from millimeters to centimeters in size and diameter | ||
* [[Venous malformations]] number range from few to hundreds | * [[Venous malformations]] number range from few to hundreds | ||
* [[Skin lesions]] have been categorised into '''3''' types | * [[Skin lesions]] have been categorised into '''3''' types<ref name="pmid191192583">{{cite journal |vauthors=Shin SH, Chae HS, Ji JS, Kim HK, Cho YS, Chang ED, Choi KY |title=A case of blue rubber bleb nevus syndrome |journal=Korean J. Intern. Med. |volume=23 |issue=4 |pages=208–12 |date=December 2008 |pmid=19119258 |pmc=2687681 |doi=10.3904/kjim.2008.23.4.208 |url=}}</ref> | ||
** '''Type 1''': Blue, rubbery, blood-filled sacs | ** '''Type 1''': Blue, rubbery, blood-filled sacs | ||
** '''Type 2''': Large, disfiguring, [[cavernous]] lesions | ** '''Type 2''': Large, disfiguring, [[cavernous]] lesions | ||
| Line 28: | Line 30: | ||
=== Extracutaneous manifestations === | === Extracutaneous manifestations === | ||
* Apart from skin the most commonly organ that is involved in patients with | * Apart from skin the most commonly organ that is involved in patients with blue rubber bleb nevus syndrome is [[Gastrointestinal tract|GI tract]]<ref name="pmid254930433">{{cite journal |vauthors=Jin XL, Wang ZH, Xiao XB, Huang LS, Zhao XY |title=Blue rubber bleb nevus syndrome: a case report and literature review |journal=World J. Gastroenterol. |volume=20 |issue=45 |pages=17254–9 |date=December 2014 |pmid=25493043 |pmc=4258599 |doi=10.3748/wjg.v20.i45.17254 |url=}}</ref> | ||
* In [[Gastrointestinal tract|GI tract]] the most commonly involved region is [[small intestine]] | * In [[Gastrointestinal tract|GI tract]] the most commonly involved region is [[small intestine]]<ref name="pmid191192582">{{cite journal |vauthors=Shin SH, Chae HS, Ji JS, Kim HK, Cho YS, Chang ED, Choi KY |title=A case of blue rubber bleb nevus syndrome |journal=Korean J. Intern. Med. |volume=23 |issue=4 |pages=208–12 |date=December 2008 |pmid=19119258 |pmc=2687681 |doi=10.3904/kjim.2008.23.4.208 |url=}}</ref> | ||
* The [[venous malformations]] in [[Gastrointestinal tract|GI tract]] are prone to bleeding | * The [[venous malformations]] in [[Gastrointestinal tract|GI tract]] are prone to bleeding<ref name="pmid29537205">{{cite journal |vauthors=Gawlikowska-Sroka A, Glura B, Mokrzycka M, Ociepa T |title=[Bean Syndrome (blue rubber bleb nevus syndrome)] |language=Polish |journal=Pomeranian J Life Sci |volume=62 |issue=2 |pages=5–7 |date=2016 |pmid=29537205 |doi= |url=}}</ref><ref name="pmid10881076">{{cite journal |vauthors=Rodrigues D, Bourroul ML, Ferrer AP, Monteiro Neto H, Gonçalves ME, Cardoso SR |title=Blue rubber bleb nevus syndrome |journal=Rev Hosp Clin Fac Med Sao Paulo |volume=55 |issue=1 |pages=29–34 |date=2000 |pmid=10881076 |doi= |url=}}</ref> | ||
* The bleeding of the [[venous malformations]] [[blue rubber bleb nevus syndrome|in]] [[Gastrointestinal tract|GI tract]] may leads to [[iron deficiency anemia]] | * The bleeding of the [[venous malformations]] [[blue rubber bleb nevus syndrome|in]] [[Gastrointestinal tract|GI tract]] may leads to [[iron deficiency anemia]]<ref name="pmid27999128">{{cite journal |vauthors=Lybecker MB, Stawowy M, Clausen N |title=Blue rubber bleb naevus syndrome: a rare cause of chronic occult blood loss and iron deficiency anaemia |journal=BMJ Case Rep |volume=2016 |issue= |pages= |date=December 2016 |pmid=27999128 |doi=10.1136/bcr-2016-216963 |url=}}</ref><ref name="pmid29851802">{{cite journal |vauthors=Tang X, Gao J, Yang X, Guo X |title=A 10-year delayed diagnosis of blue rubber bleb nevus syndrome characterized by refractory iron-deficiency anemia: A case report and literature review |journal=Medicine (Baltimore) |volume=97 |issue=22 |pages=e10873 |date=June 2018 |pmid=29851802 |doi=10.1097/MD.0000000000010873 |url=}}</ref> | ||
* In severe cases the bleeding might even leads to death | * In severe cases the bleeding might even leads to death<ref name="pmid228915662">{{cite journal |vauthors=Akutko K, Krzesiek E, Pytrus T, Iwańczak B |title=[Blue rubber bleb naevus syndrome--a rare cause of bleeding from the gastrointestinal tract--case report] |language=Polish |journal=Pol. Merkur. Lekarski |volume=32 |issue=192 |pages=394–6 |date=June 2012 |pmid=22891566 |doi= |url=}}</ref> | ||
* | |||
=== Heart === | |||
* [[Cardiovascular]] examination of patients with blue rubber bleb nevus syndrome is usually normal. | |||
=== Neuromuscular === | |||
* Blue rubber bleb nevus is positive in area like:<ref name="pmid19119258">{{cite journal |vauthors=Shin SH, Chae HS, Ji JS, Kim HK, Cho YS, Chang ED, Choi KY |title=A case of blue rubber bleb nevus syndrome |journal=Korean J. Intern. Med. |volume=23 |issue=4 |pages=208–12 |date=December 2008 |pmid=19119258 |pmc=2687681 |doi=10.3904/kjim.2008.23.4.208 |url=}}</ref> | |||
** [[Skull]] | |||
** [[CNS]] | |||
** [[Musculoskeletal system]] | |||
* | === Lungs === | ||
* [[Pulmonary hypertension]] is due [[thromboembolic]] events is noticed in some patients with [[blue rubber bleb nevus syndrome]]. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 18:28, 23 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
The presence of skin lesions on physical examination is highly suggestive of blue rubber bleb nevus syndrome.
Physical Examination
Physical examination of patients with blue rubber bleb nevus syndrome is usually remarkable for cutaneous manifestations.[1]
Appearance of the Patient
- Patients with blue rubber bleb nevus syndrome usually appear normal.
Vital Signs
- Tachycardia with regular pulse.
Skin
- Skin lesions in patients with blue rubber bleb nevus syndrome classified into:[2]
- Cutaneous and
- Extracutaneous manifestations
Cutaneous manifestations
- The skin lesions are usually multifocal venous malformations which are dark blue in colour[3][4]
- These lesions vary from millimeters to centimeters in size and diameter
- Venous malformations number range from few to hundreds
- Skin lesions have been categorised into 3 types[5]
Extracutaneous manifestations
- Apart from skin the most commonly organ that is involved in patients with blue rubber bleb nevus syndrome is GI tract[6]
- In GI tract the most commonly involved region is small intestine[7]
- The venous malformations in GI tract are prone to bleeding[8][9]
- The bleeding of the venous malformations in GI tract may leads to iron deficiency anemia[10][11]
- In severe cases the bleeding might even leads to death[12]
Heart
- Cardiovascular examination of patients with blue rubber bleb nevus syndrome is usually normal.
Neuromuscular
- Blue rubber bleb nevus is positive in area like:[13]
Lungs
- Pulmonary hypertension is due thromboembolic events is noticed in some patients with blue rubber bleb nevus syndrome.
References
- ↑ Jin XL, Wang ZH, Xiao XB, Huang LS, Zhao XY (December 2014). "Blue rubber bleb nevus syndrome: a case report and literature review". World J. Gastroenterol. 20 (45): 17254–9. doi:10.3748/wjg.v20.i45.17254. PMC 4258599. PMID 25493043.
- ↑ Akutko K, Krzesiek E, Pytrus T, Iwańczak B (June 2012). "[Blue rubber bleb naevus syndrome--a rare cause of bleeding from the gastrointestinal tract--case report]". Pol. Merkur. Lekarski (in Polish). 32 (192): 394–6. PMID 22891566.
- ↑ Jin XL, Wang ZH, Xiao XB, Huang LS, Zhao XY (December 2014). "Blue rubber bleb nevus syndrome: a case report and literature review". World J. Gastroenterol. 20 (45): 17254–9. doi:10.3748/wjg.v20.i45.17254. PMC 4258599. PMID 25493043.
- ↑ Gawlikowska-Sroka A, Glura B, Mokrzycka M, Ociepa T (2016). "[Bean Syndrome (blue rubber bleb nevus syndrome)]". Pomeranian J Life Sci (in Polish). 62 (2): 5–7. PMID 29537205.
- ↑ Shin SH, Chae HS, Ji JS, Kim HK, Cho YS, Chang ED, Choi KY (December 2008). "A case of blue rubber bleb nevus syndrome". Korean J. Intern. Med. 23 (4): 208–12. doi:10.3904/kjim.2008.23.4.208. PMC 2687681. PMID 19119258.
- ↑ Jin XL, Wang ZH, Xiao XB, Huang LS, Zhao XY (December 2014). "Blue rubber bleb nevus syndrome: a case report and literature review". World J. Gastroenterol. 20 (45): 17254–9. doi:10.3748/wjg.v20.i45.17254. PMC 4258599. PMID 25493043.
- ↑ Shin SH, Chae HS, Ji JS, Kim HK, Cho YS, Chang ED, Choi KY (December 2008). "A case of blue rubber bleb nevus syndrome". Korean J. Intern. Med. 23 (4): 208–12. doi:10.3904/kjim.2008.23.4.208. PMC 2687681. PMID 19119258.
- ↑ Gawlikowska-Sroka A, Glura B, Mokrzycka M, Ociepa T (2016). "[Bean Syndrome (blue rubber bleb nevus syndrome)]". Pomeranian J Life Sci (in Polish). 62 (2): 5–7. PMID 29537205.
- ↑ Rodrigues D, Bourroul ML, Ferrer AP, Monteiro Neto H, Gonçalves ME, Cardoso SR (2000). "Blue rubber bleb nevus syndrome". Rev Hosp Clin Fac Med Sao Paulo. 55 (1): 29–34. PMID 10881076.
- ↑ Lybecker MB, Stawowy M, Clausen N (December 2016). "Blue rubber bleb naevus syndrome: a rare cause of chronic occult blood loss and iron deficiency anaemia". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-216963. PMID 27999128.
- ↑ Tang X, Gao J, Yang X, Guo X (June 2018). "A 10-year delayed diagnosis of blue rubber bleb nevus syndrome characterized by refractory iron-deficiency anemia: A case report and literature review". Medicine (Baltimore). 97 (22): e10873. doi:10.1097/MD.0000000000010873. PMID 29851802.
- ↑ Akutko K, Krzesiek E, Pytrus T, Iwańczak B (June 2012). "[Blue rubber bleb naevus syndrome--a rare cause of bleeding from the gastrointestinal tract--case report]". Pol. Merkur. Lekarski (in Polish). 32 (192): 394–6. PMID 22891566.
- ↑ Shin SH, Chae HS, Ji JS, Kim HK, Cho YS, Chang ED, Choi KY (December 2008). "A case of blue rubber bleb nevus syndrome". Korean J. Intern. Med. 23 (4): 208–12. doi:10.3904/kjim.2008.23.4.208. PMC 2687681. PMID 19119258.