Blue Rubber Bleb Nevus syndrome

Blue Rubber Bleb Nevus syndrome

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Blue Rubber Bleb Nevus syndrome is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Bean syndrome

Disorder Subdivisions

  • None

General Discussion

Blue rubber bleb nevus syndrome (BRBNS) is a rare blood vessel (vascular) disorder that affects the skin and internal organs of the body. Multiple distinctive skin lesions are usually characteristic of this disorder and are often present at birth or present during early childhood. Lesions in the gastrointestinal tract frequently become apparent during childhood or early adulthood. The lesions are multifocal venous malformations, resulting from abnormal embryonic blood vessel development.

Symptoms

BRBNS is characterized by soft, elevated lesions on the skin or just under the skin that are dark blue, red, purple-red or black in color. The venous malformations may be tender, contain blood and be easily compressed and are usually located on the upper limbs, trunk and soles of the feet but can occur anywhere. The lesions increase in size and become more apparent over time but have not been reported to become cancerous. The organ system most commonly affected by BRBNS is the gastrointestinal (GI) tract, particularly the small intestine. The lesions in the GI tract often bleed and can lead to mild or severe anemia. Iron replacement and/or frequent blood transfusions may be required. The GI lesions can also cause an obstruction or blockage (intussusception) of part of the bowel. Skeletal abnormalities and venous malformations in muscle are sometimes associated with BRBNS.

Causes

Blue rubber bleb nevus syndrome is sporadic. Although families have been described in which the condition follows autosomal dominant inheritance, these families actually have other multifocal venous malformations.

Affected Populations

Blue Rubber Bleb Nevus Syndrome affects males and females in equal numbers. Approximately 150 cases have been reported in the medical literature.

Standard Therapies

Diagnosis

BRBNS is diagnosed by physical examination and a procedure in which the GI tract is illuminated and visualized (endoscopy). Genetic testing for BRBNS is available on a research basis only.



Treatment

Iron therapy and blood transfusions are used to conservatively manage BRBNS. The skin lesions associated with BRBNS can be treated with laser therapy, injection of chemicals that collapse the lesion (sclerotherapy) or surgical removal. Lesions in the gastrointestinal system are usually not removed unless bleeding leads to anemia and necessitates repeated blood transfusions. Gastrointestinal lesions can be safely removed surgically, but one or several lengthy operations may be required.

Investigational Therapies

Argon plasma coagulation and octreotide acetate have been described in individual cases to reduce GI bleeding, but there are no cases of prolonged durable eradication of bleeding.



Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



Contact for additional information about blue rubber bleb nevus syndrome:



Steven J. Fishman, MD

Stuart and Jane Weitzman Family Chair in Surgery

Co-Director, Vascular Anomalies Center

Department of Surgery

Children's Hospital Boston

617-355-3040 (office)

617-730-0752 (FAX)

References

TEXTBOOKS

Fishman SJ, Mulliken JB. Blue Rubber Bleb Nevus Syndrome. In: The NORD Guide to Rare Disorders, Philadelphia: Lippincott, Williams and Wilkins; 2003:160.



JOURNAL ARTICLES

Fishman SJ, Smithers CJ, Folkman J, et al: Blue rubber bleb nevus syndrome: surgical eradication of gastrointestinal bleeding. Ann Surg. 2005;5241(3): 523-8.



Apak H, Celkan T, Ozkan A, et al: Blue rubber bleb nevus syndrome associated with consumption coagulopathy: treatment with interferon. Dermatology. 2004;208:345-8.



Ng WT, Kong CK: Argon plasm coagulation for blue rubber bleb nevus syndrome in a female infant. Eur J Pediatr Surg. 2003; 13: 137-9.



Andersen JM. Blue Rubber Bleb Nevus Syndrome. Curr Treat Options Gastroenterol. 2001;4(5):433-440.



Ertem D, Acar Y, Kotiloglu E, et al: Blue rubber bleb nevus syndrome. Pediatrics. 2001; 107(2):418-20.



Gonzalez D, Elizondo BJ, Haslag S, et al: Chronic subcutaneous octreotide decreases gastrointestinal blood loss in blue rubber-bleb nevus syndrome. J Pediatr Gastroenterol Nutr. 2001;33(2): 183-8.



Bak YT, Oh CH, Kim JH, Lee CH: Blue rubber bleb nevus syndrome: endoscopic removal of the gastrointestinal hemangiomas. Gastrointest Endosc. 1997;45(1):90-2.



Morris L, Lynch PM, Gleason WA Jr, et al: Blue rubber bleb nevus syndrome: laser photocoagulation of colonic hemangiomas in a child with microcytic anemia. Pediatr Dermatol. 1992;9(2): 91-4.



INTERNET

Cherpelis BS. Blue Rubber Bleb Nevus Syndrome. eMedicine. http://emedicine.medscape.com/article/1082839-overview. Updated April 9, 2010. Accessed February 14, 2012.

Resources

Nevus Network

PO Box 305

West Salem, NC 44287

USA

Tel: (419)853-4525

Fax: (405)377-3403

Email: info@nevusnetwork.org

Internet: http://www.nevusnetwork.org/



NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

Information Clearinghouse

One AMS Circle

Bethesda, MD 20892-3675

USA

Tel: (301)495-4484

Fax: (301)718-6366

Tel: (877)226-4267

TDD: (301)565-2966

Email: NIAMSinfo@mail.nih.gov

Internet: http://www.niams.nih.gov/



Nevus Outreach, Inc.

600 SE Delaware Ave., Suite 200

Bartlesville, OK 74003

USA

Tel: (918)331-0595

Fax: (281)417-4020

Tel: (877)426-3887

Email: mbeckwith@nevus.org

Internet: http://www.nevus.org



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.