Angiodysplasia medical therapy
|
Angiodysplasia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Angiodysplasia medical therapy On the Web |
|
American Roentgen Ray Society Images of Angiodysplasia medical therapy |
|
Risk calculators and risk factors for Angiodysplasia medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nikita Singh, M.D.[2]
Overview
Treatment is not required for incidentally found, asymptomatic, non-bleeding lesions. However, it is considered for non-bleeding angiodysplasia with symptoms of occult or overt GI bleed. The invasiveness of therapy depends on clinical severity of anemia, hemodynamic stability and recurrence of symptoms. Although endoscopic techniques are the first choice, hormonal therapy, thalidomide and octreotide are the pharmacological options that have been tried for patients with significant co-morbidities who cannot undergo invasive procedures.
Medical Therapy
Pharmacological options like hormonal therapy, thalidomide, and octreotide have been tried in patients with significant co-morbidities who cannot undergo invasive procedures.
Studies have shown hormonal therapy with ethinylestradiol and norethisterone vs placebo have no difference in outcomes.[1] However, a few case series have shown positive results regarding the efficacy of hormonal therapy in chronic renal failure patients.[2]
Thalidomide inhibits angiogenesis by inhibiting vascular endothelial growth factor (VEGF)- and basic fibroblast growth factor (bFGF)-induced angiogenesis.[3]
References
- ↑ Junquera F, Feu F, Papo M, Videla S, Armengol JR, Bordas JM; et al. (2001). "A multicenter, randomized, clinical trial of hormonal therapy in the prevention of rebleeding from gastrointestinal angiodysplasia". Gastroenterology. 121 (5): 1073–9. doi:10.1053/gast.2001.28650. PMID 11677198.
- ↑ Bronner MH, Pate MB, Cunningham JT, Marsh WH (1986). "Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial". Ann Intern Med. 105 (3): 371–4. doi:10.7326/0003-4819-105-3-371. PMID 3488703.
- ↑ Chen HM, Ge ZZ, Liu WZ, Lu H, Xu CH, Fang JY; et al. (2009). "[The mechanisms of thalidomide in treatment of angiodysplasia due to hypoxia]". Zhonghua Nei Ke Za Zhi. 48 (4): 295–8. PMID 19576118.