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[Intestinal hemorrhage for 21 years in a case of blue nevus syndrome].

OBJECTIVE
To report a case of gastrointestinal bleeding due to a blue rubber bleb nevus syndrome undiagnosed for 21 years.


CASE
A woman of 28 years of age suffered chronic gastrointestinal bleeding starting at seven years of age. During these 21 years she received various treatment with oral and parenteral iron and, in addition, four blood transfusions. We found her to be anemic with 7.8 g/dL of hemoglobin (HB), iron deficient and with skin lesions in tongue, right hand and lower extremities. A skin biopsy diagnosed the lesions as cavernous hemangiomas. Multiple intestinal hemangiomas seen by radiologic, endoscopic and colonoscopic studies, established the diagnosis. She was treated with oral iron; three months later she was asymptomatic and with higher levels of HB (9.1 g/dL).


CONCLUSION
The rarity of the syndrome and the fact that, as far as we know, it is the first case reported in Mexico, probably led to a delay in its diagnosis and to potentially dangerous therapy in this patient in spite of the fact that the diagnosis was not difficult.