H.L.M.
Hereditary hemorrhagic telangiectasia, also called Osler-Weber-Rendu syndrome, is an uncommon but not rare syndrome of abnormal blood vessels. The “hereditary” part tells us that this is a genetic disease, but at least three different genes are involved, and the variations between one person and another with this condition are very wide.
“Hemorrhagic” means bleeding — the type of bleeding you have from the fingers is common, but so are nosebleeds and bleeding internally from the GI tract. A “telangiectasia” is an abnormality of blood vessels in which arteries in the skin connect directly to veins. These can bleed much more easily than normal skin.
HHT is a condition that many doctors are unfamiliar with, so it may be worthwhile to see an expert, someone who can help your local doctor treat you.
Dear Dr. Roach: I have been taking thyroid medication for 15 years. Ten months ago I had a normal TSH level. Last week it was slightly low. During this period I developed trigger finger on the middle digit of both hands.
Does the drop in my TSH signify hypothyroid? And is it possible to develop trigger finger due to hypothyroidism? I wondered if I should change my dosage of thyroid meds to see if this helps my hands, but my doctor said no.
J.R.
Trigger finger is a condition where the tendon to the finger gets stuck in its sheath, sometimes painfully. It usually is treated by an orthopedic surgeon with an injection, although it sometimes needs surgery. Hypothyroidism does make this condition more likely, but there isn’t a consensus on why it happens. Untreated hypothyroidism can cause swelling in soft tissues, and this may be the problem.
Because your TSH was slightly low, if your doctor was to make any change, it would be to slightly decrease the dose of replacement hormone.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@
med.cornell.edu.
