{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:06:43Z","timestamp":1780092403600,"version":"3.54.0"},"reference-count":32,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Hereditary Hemorrhagic Telangiectasia (HHT) is a vascular autosomically inherited rare disease. Epistaxis (nose bleeds) is the most common symptom in HHT, leading to anemia and affecting the patient\u2019s quality of life. In addition to epistaxis, gastrointestinal bleeding (GI), more often at older ages, may lead to severe anemia and the need for blood transfusions. Thus, finding drugs to control both types of bleeding is a primary necessity in HHT. Methods: A cross-sectional observational study was conducted in a series of 11 HHT patients treated with low tacrolimus doses (0.5\u20132 mg\/day) on an off-label prescription basis. Patients showed refractory bleeding to previous treatments. The epistaxis severity score (ESS) and hemoglobin levels were the parameters used to evaluate the impact of tacrolimus. The occurrence of side effects was also recorded. Results: Tacrolimus was well tolerated in all of the patients except 2 (who stopped the treatment). The remaining patients tolerated the treatment, with a general improvement in their health condition. Epistaxis was significantly reduced when comparing the ESS before and after the treatment. Hemoglobin levels significantly increased, overcoming the anemia, during the course of the treatment. Conclusion: Tacrolimus at low doses should be considered as a promising treatment for epistaxis and gastrointestinal bleeding in HHT.<\/jats:p>","DOI":"10.3390\/jcm12237410","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T12:01:00Z","timestamp":1701259260000},"page":"7410","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Tacrolimus as a Promising Drug for Epistaxis and Gastrointestinal Bleeding in HHT"],"prefix":"10.3390","volume":"12","author":[{"given":"Paloma","family":"\u00c1lvarez-Hern\u00e1ndez","sequence":"first","affiliation":[{"name":"Otorrhinolaringology Department, Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Patier","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Universitario Ram\u00f3n y Cajal, Instituto Ram\u00f3n y Cajal Investigaci\u00f3n Sanitaria, IRYCIS, 28034 Madrid, Spain"},{"name":"Faculty of Medicine and Health Sciences, Universidad de Alcal\u00e1 (UAH), 28801 Alcal\u00e1 de Henares, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sol","family":"Marcos","sequence":"additional","affiliation":[{"name":"Otorrhinolaringology Department, Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"G\u00f3mez del Olmo","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Universitario Ram\u00f3n y Cajal, Instituto Ram\u00f3n y Cajal Investigaci\u00f3n Sanitaria, IRYCIS, 28034 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lorente-Herraiz","sequence":"additional","affiliation":[{"name":"CIBER Rare Diseases Unit 707, Centro de Investigaciones Biol\u00f3gicas Margarita Salas, Consejo Superior Investigaciones Cient\u00edficas, CSIC, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Recio-Poveda","sequence":"additional","affiliation":[{"name":"CIBER Rare Diseases Unit 707, Centro de Investigaciones Biol\u00f3gicas Margarita Salas, Consejo Superior Investigaciones Cient\u00edficas, CSIC, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6310-2245","authenticated-orcid":false,"given":"Luisa Mar\u00eda","family":"Botella","sequence":"additional","affiliation":[{"name":"CIBER Rare Diseases Unit 707, Centro de Investigaciones Biol\u00f3gicas Margarita Salas, Consejo Superior Investigaciones Cient\u00edficas, CSIC, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5924-2280","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Viteri-No\u00ebl","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Universitario Ram\u00f3n y Cajal, Instituto Ram\u00f3n y Cajal Investigaci\u00f3n Sanitaria, IRYCIS, 28034 Madrid, Spain"},{"name":"Faculty of Medicine and Health Sciences, Universidad de Alcal\u00e1 (UAH), 28801 Alcal\u00e1 de Henares, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Albi\u00f1ana","sequence":"additional","affiliation":[{"name":"CIBER Rare Diseases Unit 707, Centro de Investigaciones Biol\u00f3gicas Margarita Salas, Consejo Superior Investigaciones Cient\u00edficas, CSIC, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/(SICI)1096-8628(20000306)91:1<66::AID-AJMG12>3.0.CO;2-P","article-title":"Diagnostic criteria for Hereditary Hemorrhagic Telangiectasia (RenduOsler-Weber Syndrome)","volume":"91","author":"Shovlin","year":"2000","journal-title":"Am. 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