title: Severe gastrointestinal bleeding in a uremic patient treated with estrogen-progesterone therapy.
abstract: Gastrointestinal bleeding is a frequent complication in hemodialysis patients; angiodysplasia is a potential cause, with a higher incidence in uremic patients. We describe a case of severe anemia (Hemoglobin up to 3.5 g/dl) secondary to diffuse angiodysplastic lesions in a hemodialysis patient with mixed connective tissue disease. The case is characterised both by the severity of the clinical picture (extension and entity of angiodysplastic lesions, frequency of bleeding episodes) and by the patient's religious faith which made her reject blood transfusions. We underline the efficacy of estrogen-progesterone therapy in view of the modest results obtained with other therapeutic strategies on bleeding.
authors.affiliation: Department of Clinical Medicine and Applied Biotechnology, S. Orsola University Hospital, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mosconi
authors.forename: E
authors.initials: E
authors.lastname: Mambelli
authors.forename: F
authors.initials: F
authors.lastname: Zanchelli
authors.forename: E
authors.initials: E
authors.lastname: Isola
authors.forename: C
authors.initials: C
authors.lastname: Perna
authors.forename: A
authors.initials: A
authors.lastname: De Pascalis
authors.forename: C
authors.initials: C
authors.lastname: Raimondi
authors.forename: M
authors.initials: M
authors.lastname: Ventrucci
authors.forename: S
authors.initials: S
authors.lastname: Stefoni
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology; D016888:Angiodysplasia / Q000150:complications / Q000188:drug therapy; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D008947:Mixed Connective Tissue Disease / Q000150:complications; D009640:Norethindrone / Q000008:administration & dosage* / Q000009:adverse effects; D045167:Progesterone Congeners / Q000008:administration & dosage* / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects; D014511:Uremia / Q000150:complications* / Q000628:therapy
chemical_list: D045167:Progesterone Congeners; C121824:ethylenestradiol; D004958:Estradiol; D009640:Norethindrone