Duarte Bruno K L, de Souza Sílvia M, Costa-Lima Carolina, Medina Samuel S, Ozelo Margareth C
Instituto Nacional de Ciência e Tecnologia do Sangue, Hemocentro Unicamp, Campinas, SP, Brazil.
Department of Internal Medicine, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
Hematol Rep. 2017 Jun 15;9(2):6961. doi: 10.4081/hr.2017.6961. eCollection 2017 Jun 1.
Angiodysplasia is a frequent cause of persistent gastrointestinal (GI) hemorrhage in elderly patients. Although GI bleeding isn't the most common manifestation in patients with bleeding disorders, when present, it represents a challenging complication. We describe a 62-year-old patient with Glanzmann's thrombasthenia, who used thalidomide for severe and recurrent GI bleeding. For 6 months, the patient experienced temporary control of GI bleeding with thalidomide in a daily oral dose of 100 mg. The anti-angiogenic effects of thalidomide have recently been explored by several groups, particularly in the management of bleeding from angiodysplasia, including cases with von Willebrand disease. Here, we review the relevant descriptions of the use of thalidomide in this situation, and also discuss potential reasons why we observed only a temporary control of the GI bleeding in our patient, such as the use of low-dose regimen due to limitations posed by thalidomide side effects.
血管发育异常是老年患者持续性胃肠道（GI）出血的常见原因。虽然GI出血并非出血性疾病患者最常见的表现，但一旦出现，就代表着一种具有挑战性的并发症。我们描述了一名62岁患有Glanzmann血小板无力症的患者，该患者使用沙利度胺治疗严重且复发性的GI出血。在6个月的时间里，该患者通过每日口服100mg沙利度胺实现了GI出血的临时控制。最近，几个研究小组探讨了沙利度胺的抗血管生成作用，特别是在治疗血管发育异常引起的出血方面，包括患有血管性血友病的病例。在此，我们回顾了沙利度胺在这种情况下使用的相关描述，并讨论了为什么我们观察到该患者的GI出血只是得到了临时控制的潜在原因，例如由于沙利度胺副作用的限制而使用了低剂量方案。
