Thalidomide for recurrent gastrointestinal bleeding caused by angiodysplasia: report of one case].

Jorge Vega, Helmuth Goecke, M De Los Ángeles Rodríguez, M Teresa Vergara

Sección de Nefrología, Servicio de Medicina Interna, Hospital Naval Almirante Nef, Viña del Mar, Chile. jvegastieb@gmail.com

Revista médica de Chile 2011 Jul

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Chronic hemodialysis patients may have recurrent bleeding from gastrointestinal angiodysplasia, that often is diffusely located in the digestive tract or in places difficult to reach with traditional endoscopes. Therefore, they cannot be locally treated or removed. We report a 70 years old man on chronic hemodialysis, with severe and persistent anemia due to bleeding from angiodysplasia of the small bowel. Despite administration of high doses of erythropoiesis stimulating agents, intravenous iron, folate, B6 and B12 vitamins, his hemoglobin levels were < 6.5 g/dL, becoming totally dependent on transfusions of red blood cells (up to 46 units per year). Recurrent bleeding was refractory to conventional management and we decided to use thalidomide at doses of 50-100 mg/day achieving rapid control of gastrointestinal bleeding and significant increase of hemoglobin levels, not requiring further transfusions.

Citation

Jorge Vega, Helmuth Goecke, M De Los Ángeles Rodríguez, M Teresa Vergara. Thalidomide for recurrent gastrointestinal bleeding caused by angiodysplasia: report of one case]. Revista médica de Chile. 2011 Jul;139(7):909-13