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Hormone therapy for severe gastrointestinal bleeding due to multiple angiodysplastic lesions

Torrente Iranzo, Silviaa; Sarasqueta Eizaguirre, Cristinab; Gonzalez Canalizo, Valentina; Segues Merino, Nerea M.a; Ortega Rezola, Paulaa; Wong Arteta, Jhonatana; Medina Del Valle, Andreaa; Cosme Jimenez, Ángela; Bujanda, Luisa,b

European Journal of Gastroenterology & Hepatology: March 2019 - Volume 31 - Issue 3 - p 312–315
doi: 10.1097/MEG.0000000000001139
Original Articles: Gastroenterology

Objective This study aims to assess the efficacy of hormone therapy in patients with severe gastrointestinal bleeding due to multiple angiodysplastic lesions.

Patients and methods Between May 2010 and July 2017, we included 12 consecutive patients with anaemia or recurrent bleeding due to angiodysplasia who had been started on hormone therapy. The therapy given was a combination of levonorgestrel (between 0.10 and 0.25 mg) and ethinylestradiol (between 0.02 and 0.05 mg). We determined the mean number of transfusions required in the 6 months before and after the start of the treatment, as well as the mean haemoglobin levels, number of admissions for anaemia due to gastrointestinal bleeding and length of hospital stay in these periods.

Results The mean age of patients included was 77.83 years old and 75% were male. The follow-up period after treatment initiation was 6 months. Of the 12 patients included, only one stopped the treatment owing to it not being effective. Overall, 83.3% of the patients reported subjective improvement. Furthermore, we found significant differences comparing before and after starting treatment regarding the mean number of transfusions (7±4.8 vs. 3.4±4.6; P=0.005), the mean haemoglobin levels (9.5±1.2 vs. 10.8±2.6; P=0.034) and the mean number of admissions (1.6±1.6 vs. 0.2±0.4; P=0.024). On the contrary, differences between pretreatment and post-treatment length of hospital stay were not significant.

Conclusion Hormone therapy is a potentially useful therapeutic tool in patients with refractory bleeding and anaemia due to angiodysplasia.

aDepartment of Gastroenterology, Donostia University Hospital

bDepartment of Gastroenterology, Biodonostia Medical Research Institute, San Sebastian, Spain

Correspondence to Silvia Torrente Iranzo, MD, Department of Gastroenterology, Donostia University Hospital, Doctor Begiristain street,109, 20014 San Sebastian, Spain Tel: +34 94 300 7173; fax: +34 94 300 7065; e-mail: siltorrenteir@gmail.com

Received December 22, 2017

Accepted March 22, 2018

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