[Cerebral abscesses disclosing pulmonary angioma. Rendu-Osler disease]

A 50-year old male patient presented with two successive cerebral abscesses over a 9-month period. Rendu-Osler-Weber disease was diagnosed on the basis of recurrent epistaxis and telangiectasis of the mucosae and skin. In addition, many members of the patient's family had a history of epistaxis and one had a cerebral angioma of unusual location. Our patient's chest was normal on physical and radiological examination, but pulmonary angiography disclosed a small angioma. Removal of the angioma prevented further cerebral infections. The prevalence of pulmonary arterio-venous fistulae in Rendu-Osler-Weber disease and their clinical manifestations (especially in the central nervous system) are reviewed, together with the value of family studies and the therapeutic approach.