Thalidomide treatment in cirrhotic patients with severe anemia secondary to vascular malformations.

摘要: The treatment of cirrhotic patients presenting with recurrent bleeding due to gastrointestinal vascular malformations poses a challenge physicians [1]. aim the present report is assess efficacy thalidomide in multitransfused (GIB) who do not respond favorably either conventional drug therapy or endoscopic and angiographic techniques. We carried out prospective study 19 GIB, ectasia/vascular lesions/ portal hypertensive gastropathy (PHG), did received treatment. For each patients, we considered: age, sex, cirrhosis etiology functional class, previous octreotide therapy, regimen duration treatment, mean hemoglobin concentration during 6 months prior onset increase values. also determined reduction number transfusions after as well safety negative side effects All this information was analyzed using descriptive statistics SPSS v.16. included our GIB: 12 males 7 females. Average age 71; cirrhosis: alcohol 8 HCV 7, HBV 1, autoimmune origin 1 patient, NASH another patient cryptogenetic patient. Child A 8/19 (42.1%), B 5/19 (26.6%), C 6/19 (31.3%). Of , 100% had previously been treated argon plasma coagulation without positive response. dose used 200 mg/24 h 4 for most patients. Mean g/dL before 9 2 10 at end (P = 0.0471). Eight (42%) presented hepatic encephalopathy episodes them requiring withdrawal. Another abandoned clinical symptoms; further sensitive axonal polyneuropathy which resolved withdrawal Two died study, both Pough cirrhosis. presence high levels endothelial growth factor (VEGF) promotes aberrant angiogenesis formation angiodysplasias endothelium lacking smooth muscle cells therefore prone ruptures. Thalidomide potent anti-angiogenic effect inhibits VEGF reduces its level significantly So far, few reports have published cases small series showing [1, 2], PHG [3] severe proctitis following radiotherapy [4]. Endoscopic capsule examination shows size lesions receiving hemorrhage control follow-up period 2–3 years [5]. In general, reported are (fatigue, peripheral neuropathy, skin rash) [2]. This suggests that it necessary consider point should be introduced these [6]. A. Garrido Serrano (&) R. Leon M. Sayago J. L. Marquez Department Digestive Diseases, University Hospital Virgen del Rocio, c/Carmen de Burgos, 19. Tomares, 41940 Seville, Spain e-mail: agarser@telefonica.net