Back to Search
Start Over
Treatment of Chronic Bleeding From Gastric Antral Vascular Ectasia (GAVE) With Estrogen-Progesterone in Cirrhotic Patients: An Open Pilot Study.
- Source :
- American Journal of Gastroenterology (Springer Nature); Oct1999, Vol. 94 Issue 10, p2909-2911, 3p, 1 Chart, 1 Graph
- Publication Year :
- 1999
-
Abstract
- OBJECTIVE: Gastric antral vascular ectasia (GAVE) is a rare cause of chronic bleeding in cirrhotic patients. Treatment of GAVE with surgical or nonsurgical portal decompression, β-blockers, or endoscopic therapy provides disappointing results. In the present study, we evaluated the efficacy of estrogen-progesterone therapy, which has been reported to control chronic bleeding in gastrointestinal vascular malformations, such as Osler-Weber Rendu disease or angiodysplasia. in GAVE-related chronic bleeding. METHODS: Six cirrhotic patients who bled chronically from GAVE were included. Three had alcoholic cirrhosis, two cryptogenic cirrhosis, and one primary biliary cirrhosis. Grade I esophageal varices were noted in four patients. Bleeding could not be controlled by β-blockers, and endoscopic therapy was not considered given the extension of the antral vascular lesions. RESULTS: Before the start of therapy, transfusion requirements averaged 3.5 units/month over a 1.5-11 month period of observation. Patients were then treated with a combination of ethynil estradiol 30µg and noretisterone 1.5 mg daily. During follow-up (range 3-12 months), bleeding did not recur in four patients; in one patient, treatment with estrogen progesterone decreased the need for transfusions from 4 units/month to 1.4 unit/month: this patient stopped the treatment inadvertently after 6 months and severe anemia recurred with a need for 4 units of blood in the following month; reintroduction of the treatment resulted in an increase of hemoglobin levels without the need for blood transfusions during the following 4 months, ln the last patient, a 5-month treatment did not improve chronic bleeding. CONCLUSIONS: The present study suggests that estrogen-progesterone therapy is useful in the treatment of chronic bleeding related to GAVE; however, these findings require confirmation by a controlled trial. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00029270
- Volume :
- 94
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- American Journal of Gastroenterology (Springer Nature)
- Publication Type :
- Academic Journal
- Accession number :
- 17665372
- Full Text :
- https://doi.org/10.1111/j.1572-0241.1999.01436.x