Blue Rubber Bleb Nevus Syndrome

Federica Sullo, Angela D'Ambra, Andrea D. Praticò, Agata Polizzi, Maria Teresa Garozzo, Flavia La Mendola, Concetta Pirrone, Elena Commodari, Carmelo Schepis, Francesco Lacarrubba, Giuseppe Micali, Enrica Quattrocchi, Antonio Zanghì, Martino Ruggieri

Research output: Contribution to journalReview article

Abstract

Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital disorder characterized by multifocal venous malformations mainly of the skin, soft tissue, and gastrointestinal tract. However, it may occur in any tissue including the nervous system. This syndrome most commonly occurs sporadically but can be associated with an autosomal dominant inheritance. Among the cases reported in the literature, the female/male ratio was ∼1:1. The diagnosis of BRBNS is based on the presence of characteristic cutaneous lesions with or without gastrointestinal bleeding and/or the involvement of other organs. Typical skin manifestations consist of soft, easily compressive, bluish papules similar to rubber-like nipples. Aside the skin, vascular lesions are usually found in the gastrointestinal tract, anywhere from the oral to the anal mucosa, but predominantly in the small bowel. Endoscopy provides the opportunity to treat and diagnose the lesions. BRBNS should be differentiated from hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome), Klippel-Trenaunay syndrome, and Maffucci syndrome. The prognosis of BRBNS depends on which organs are involved and the extent of involvement. Most patients can live a long life with the disease, but the quality of life is limited due to gastrointestinal bleeding, oral drug therapy, and blood transfusions. Sudden massive gastrointestinal hemorrhage remains the most frequent cause of death. No curative therapy is currently available for this syndrome. The cutaneous lesions are usually asymptomatic and do not require treatment. The most important clinical problem is the management of acute or chronic bleeding from the multiple gastrointestinal venous malformations: a conservative approach should be instituted whenever the clinical features and the bleeding episodes are mild and only in a life-threatening situation surgery may be required. In the recent years, however, molecular targeted therapy with the mammalian target of rapamycin inhibitor sirolimus has been anecdotally employed with reduction in bleeding and shrinkage of vascular malformations.

Original languageEnglish
Pages (from-to)288-296
Number of pages9
JournalJournal of Pediatric Neurology
Volume16
Issue number5
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Hemorrhage
Hereditary Hemorrhagic Telangiectasia
Skin
Sirolimus
Gastrointestinal Tract
Enchondromatosis
Klippel-Trenaunay-Weber Syndrome
Molecular Targeted Therapy
Skin Manifestations
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Vascular Malformations
Gastrointestinal Hemorrhage
Nipples
Rubber
Blood Transfusion
Nervous System
Endoscopy
Blood Vessels
Cause of Death
Mucous Membrane

Keywords

  • blue rubber bleb nevus
  • dermatology
  • extracutaneous lesions
  • gastrointestinal bleeding
  • hemorrhage
  • sirolimus
  • syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Sullo, F., D'Ambra, A., Praticò, A. D., Polizzi, A., Garozzo, M. T., Mendola, F. L., ... Ruggieri, M. (2018). Blue Rubber Bleb Nevus Syndrome. Journal of Pediatric Neurology, 16(5), 288-296. https://doi.org/10.1055/s-0038-1667178

Blue Rubber Bleb Nevus Syndrome. / Sullo, Federica; D'Ambra, Angela; Praticò, Andrea D.; Polizzi, Agata; Garozzo, Maria Teresa; Mendola, Flavia La; Pirrone, Concetta; Commodari, Elena; Schepis, Carmelo; Lacarrubba, Francesco; Micali, Giuseppe; Quattrocchi, Enrica; Zanghì, Antonio; Ruggieri, Martino.

In: Journal of Pediatric Neurology, Vol. 16, No. 5, 01.01.2018, p. 288-296.

Research output: Contribution to journalReview article

Sullo, F, D'Ambra, A, Praticò, AD, Polizzi, A, Garozzo, MT, Mendola, FL, Pirrone, C, Commodari, E, Schepis, C, Lacarrubba, F, Micali, G, Quattrocchi, E, Zanghì, A & Ruggieri, M 2018, 'Blue Rubber Bleb Nevus Syndrome', Journal of Pediatric Neurology, vol. 16, no. 5, pp. 288-296. https://doi.org/10.1055/s-0038-1667178
Sullo F, D'Ambra A, Praticò AD, Polizzi A, Garozzo MT, Mendola FL et al. Blue Rubber Bleb Nevus Syndrome. Journal of Pediatric Neurology. 2018 Jan 1;16(5):288-296. https://doi.org/10.1055/s-0038-1667178
Sullo, Federica ; D'Ambra, Angela ; Praticò, Andrea D. ; Polizzi, Agata ; Garozzo, Maria Teresa ; Mendola, Flavia La ; Pirrone, Concetta ; Commodari, Elena ; Schepis, Carmelo ; Lacarrubba, Francesco ; Micali, Giuseppe ; Quattrocchi, Enrica ; Zanghì, Antonio ; Ruggieri, Martino. / Blue Rubber Bleb Nevus Syndrome. In: Journal of Pediatric Neurology. 2018 ; Vol. 16, No. 5. pp. 288-296.
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