Journal Article10.7326/0003-4819-105-3-371
Estrogen-progesterone therapy for bleeding gastrointestinal telangiectasias in chronic renal failure. An uncontrolled trial.
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TL;DR: In this article, the authors treated seven patients with chronic renal failure and bleeding gastrointestinal telangiectasias with systemic estrogen or estrogen-progesterone in an uncontrolled trial.
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Abstract: Gastrointestinal telangiectasias cause hemorrhage in patients with chronic renal failure. Therapies using vasoconstrictors, endoscopic application of heat, and surgery have had limited efficacy. Because several reports have suggested that estrogen or estrogen-progesterone therapy may control mucosal bleeding from telangiectasias in patients with hereditary hemorrhagic telangiectasia, we treated seven patients with chronic renal failure and bleeding gastrointestinal telangiectasias with systemic estrogen or estrogen-progesterone in an uncontrolled trial. Bleeding ceased in all patients. Blood transfusion requirements decreased from a mean of 1.2 U/month before treatment to 0.21 U/month after treatment. No significant side effects were noted. Results of this trial indicate the need for controlled investigations of this type of hormonal therapy.
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TL;DR: Careful assessment of both the patient's clinical situation and laboratory findings is important for tailoring therapy of the bleeding patient.
Medical Therapy for Chronic Gastrointestinal Bleeding of Obscure Origin
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References
On the Nature and Etiology of Vascular Ectasias of the Colon: Degenerative lesions of aging
Scott J. Boley,Robert J. Sammartano,Anne Adams,Anthony DiBiase,Sylvain Kleinhaus,Seymour Sprayregen +5 more
TL;DR: These investigations suggested that vascular ectasias developing as a degenerative process of aging, are present with or without bleeding in a significant portion of the population over 60 years of age, are multiple more often than single, and may represent the commonest cause of major lower intestinal bleeding in the elderly.
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Upper gastrointestinal bleeding in patients with chronic renal failure
TL;DR: These data show that the differential diagnoses of first and subsequent upper gastrointestinal bleeding sites differ for patients with and without chronic renal failure.
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Bleeding time in uremia: a useful test to assess clinical bleeding.
TL;DR: Modified Ivy bleeding time (template) and platelet aggregation to ADP, epinephrine, and collagen were studied in 26 uremic patients who had not recently ingested anti‐platelet drugs, and aggregometric patterns differed between drug‐induced and Uremic thrombocytopathies.
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Gastrointestinal angiodysplasia associated with aortic valve disease: part of a spectrum of angiodysplasia of the gut.
TL;DR: It is suggested that angiodysplasia of the gastrointestinal tract can be regarded as a spectrum with a clearly inherited etiology on one extreme and an acquired etiology for a subset of patients associated with aortic valve disease.
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