Therapeutic failure with thalidomide in patients with recurrent intestinal bleeding due to angiodysplasias

Farm Hosp. 2016 May 1;40(3):230-2. doi: 10.7399/fh.2016.40.3.10456.

Abstract

Angiodysplasias are one of the reasons of gastrointestinal bleeding, whose origin is usually due to vascular malformations. There are different types of therapies for angiodysplasia such as endoscopic, angiographic and pharmacological techniques. Among the last ones, there is little variety of effective drugs to treat the disease. We describe the therapeutic failure with thalidomide in a male with recurrent gastrointestinal bleeding due to angiodysplasias. A thorough diagnostic work-up, including gastroscopy, enteroscopy, angiography and capsule endoscopy were performed. Despite treatment with high-dose somatostatin analogues and oral iron, the patient continued bleeding. The patient was administered then thalidomide for three months with no clinical response. Thalidomide had to be withdrawn owing to adverse effects.

Una de las causas de sangrado a nivel gastrointestinal son las angiodisplasias, cuyo origen suele deberse a malformaciones a nivel vascular. Existen distintos tipos de terapias para las angiodisplasias, como son las técnicas endoscópicas, angiográficas y farmacológicas. Dentro de estas últimas existe poca variedad de fármacos efectivos para dicha patología. Se describe el fracaso terapéutico con talidomida en un varón con sangrado gastrointestinal recurrente debido a angiodisplasias. Se le realiza un diagnóstico completo, incluyendo gastroscopia, enteroscopia, angiografía y cápsula endoscópica. A pesar del tratamiento con análogos de la somatostatina a altas dosis y hierro oral, el paciente continuó sangrando. El paciente recibió talidomida durante tres meses sin respuesta clínica. La talidomida tuvo que ser retirada debido a los efectos adversos y a la falta de eficacia.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anemia / etiology
  • Angiodysplasia / complications*
  • Angiodysplasia / drug therapy*
  • Gastrointestinal Hemorrhage / drug therapy*
  • Gastrointestinal Hemorrhage / etiology*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Male
  • Melena / etiology
  • Thalidomide / therapeutic use*
  • Treatment Failure

Substances

  • Immunosuppressive Agents
  • Thalidomide