Blue Rubber Bleb Nevus Syndrome (BRBNS)

What is blue rubber bleb nevus syndrome?

Blue rubber bleb nevus syndrome (BRBNS), sometimes called Bean syndrome, is a rare congenital vascular anomaly in which malformed veins, or blebs, appear on the skin and surfaces of internal organs. These small, purple lesions are particularly common in the gastrointestinal (GI) tract.

While a child with BRBNS can have hundreds of blebs on the skin, clinicians are generally more concerned with GI blebs, as they can bleed and cause anemia requiring iron supplements and blood transfusions.

There is no single accepted treatment for blue rubber bleb nevus syndrome. Both GI and skin blebs can be treated with surgery or sclerotherapy. However, doctors typically leave blebs on the skin alone unless they cause cosmetic problems, pain or, if located on the soles of the feet, difficulty walking.

Blebs can appear and grow throughout a child’s lifetime, but those that are removed do not return.

How we care for blue rubber bleb nevus syndrome

The Vascular Anomalies Center's (VAC) interdisciplinary team of clinicians cares for children with blue rubber bleb nevus syndrome. The VAC's 25 physicians—representing 16 medical and surgical specialties—are experts in the field of vascular anomalies. Ours is one of the few centers in the world specializing in surgical treatment of BRBNS, especially surgical removal of blebs that appear in the gastrointestinal tract or large masses in and under the skin. Although the condition is very rare, the VAC team treats BRBNS patients commonly.

Specialists from multiple disciplines come together to care for every child seen at the VAC clinic. It's not uncommon for children on their first visit to the clinic to be evaluated by a whole team at the same time. From there, the team works with you to develop and carry out a comprehensive and coordinated care plan that matches your child's specific needs, bringing in the expertise of other Boston Children's departments and services as necessary to provide your child with the best care.