William Osler on telangiectatic syndromes

Osler's description of recurrent mucous membrane bleeding from multiple cutaneous telangiectases was initially published in 1901. He credited Rendu's 1896 report of a 52-year-old man with telangiectases of the lips, nose, soft palate, and tongue who had recurrent epistaxis. Other physicians earlier had noted vascular nevi in familial epistaxis and had suggested a variant of hemophilia as the etiology. Osler clearly stated in his 1901 report that this disease was unrelated to hemophilia. Rendu noted the widespread nature of these telangiectases, and Osler observed that visceral telangiectases may be present with diverse hemorrhagic manifestations. In 1909, Hanes called the disease “hereditary hemorrhagic telangiectasias,” but it is often referred to as Osler-Weber-Rendu disease, recognizing the contributions of these 3 physicians in presenting clinical examples of this disorder. Osler's contribution to telangiectatic syndromes is explored, emphasizing his remarkable observational skills and his ability to correlate clinical findings. Current concepts of pathogenesis and treatment are discussed in a historical context.