HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Post, M. C. Articles by Westermann, C. J. J. Search for Related Content PubMed PubMed Citation Articles by Post, M. C. Articles by Westermann, C. J. J.

A Pulmonary Right-to-Left Shunt in Patients With Hereditary Hemorrhagic Telangiectasia Is Associated With an Increased Prevalence of Migraine^*

^* From the Departments of Cardiology (Drs. Post, Plokker, and Kelder) and Pulmonology (Drs. Letteboer, Mager, and Westermann), St. Antonius Hospital, Nieuwegein, the Netherlands.

Correspondence to: Cornelius J. J. Westermann, MD, PhD, Department of Pulmonology, St. Antonius Hospital., 3435 CM Nieuwegein, The Netherlands; e-mail: e.blokland{at}antonius.net

Introduction: Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal-dominant vascular dysplasia with a high prevalence of pulmonary arteriovenous malformation (PAVM). Recent studies report an increased prevalence of migraine in patients with a cardiac right-to-left shunt. The aim of our study was to evaluate whether there is also an increased prevalence of migraine in patients with a pulmonary right-to-left shunt (PAVM).

Methods: All patients with HHT referred to our hospital till April 2004 with or without PAVM and with or without migraine were included in the study.

Results: In total, 538 HHT patients (41.6% men; mean age ± SD, 39.3 ± 18.6 years) could be included. PAVM was present in 208 patients (38.7%; mean age, 39.3 ± 17.6 years). Significantly more women were present in the PAVM subgroup compared to the non-PAVM subgroup, 65.4% vs 53.9% (p = 0.009). Migraine occurred in 88 patients with HHT, a prevalence of 16.4%. The prevalence of migraine in women with HHT was significantly higher compared to men, 19.4% vs 12.1%, respectively (p = 0.03) The prevalence of migraine in patients with PAVM was 21.2%, which was significantly higher then in patients without PAVM, 13.3% (p = 0.02). The occurrence of PAVM in the patients with migraine is significantly higher than in those without migraine, 50.0% vs 36.4%, respectively (p = 0.02).

Conclusion: This study showed a higher prevalence of PAVM in patients with migraine and HHT. The right-to-left shunt due to the PAVM might play a causal role in the pathogenesis of migraine in patients with HHT. This needs to be determined in further studies.

Key Words: hereditary hemorrhagic telangiectasia • migrane • pulmonary arteriovenous malformation • right-to-left shunt

This article has been cited by other articles:

				K. L. Hackelton Acute Visual Loss as the Presenting Complaint of Hereditary Hemorrhagic Telangiectasia J Am Board Fam Med, November 1, 2006; 19(6): 637 - 640. [Abstract] [Full Text] [PDF]

				M. C. Post and W. Budts The Relationship Between Migraine and Right-to-Left Shunt: Fact or Fiction? Chest, September 1, 2006; 130(3): 896 - 901. [Abstract] [Full Text] [PDF]