Tourniquet-Test – An additional diagnostic tool in diagnosis of hereditary haemorrhagic telangiectasia?

Introduction The Tourniquet test is used as a diagnostic procedure for increased bleeding tendency due to e.g. thrombocytopathies and vascular diseases and is also mentioned in textbooks for hereditary haemorrhagic telangiectasia (HHT). To our knowledge, there is a lack of evidence for the latter and this was the aim of our investigations.

Material and methods We performed the Tourniquet test in patients with a confirmed diagnosis of HHT (≥3 Curaçao criteria or positive molecular genetics). If the test result was positive (≥10 petechiae), extended coagulation diagnostics were performed wherever possible.

Results A total of 92 patients with HHT were included (62% women), of whom 44 patients (48%) tested positive. Neither the overall test result nor the number of petechiae showed statistically significant correlations with individual patient characteristics including severity of the disease (Epistaxis Severity Score, Toronto Severity Score), use of anticoagulant or antiplatelet medication, or laboratory parameters including platelet count. Coagulation could be further analysed in 23 patients who tested positive and only two patients were found to have slightly reduced factor activities (IX and X).

Discussion The test was positive in 48% of those affected, which is relatively high compared to other areas of application. This indicates an increased vulnerability of the vessels to pressure in HHT, which to our knowledge has not yet been described.

 

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Publication History

Article published online:
19 April 2024