Timeline:
His condition has started since his childhood when he presented with same symptoms for which his labs showed thrombocytopenia (15 thousands/cmm) that the bone marrow sample has confirmed. Therefore, he was diagnosed as idiopathic thrombocytopenic purpura (ITP) for which steroids have been started with no improvement and he continued to have many bleeding episodes. He was admitted last time few months ago with large amounts of bleeding from his right nostril. A more detailed history and examination was intriguing for hereditary hemorrhagic telangiectasia. Based on the presence of epistaxis, telangiectasias and a first-degree relative with HHT confirmed using the Curacoa criteria.