title: Use of conjugated estrogens in life-threatening gastrointestinal bleeding in hemodialysis patients--a review.
abstract: Hormonal agents (estrogen and progesterone) are being studied for their use in bleeding. This observance was initially explored in a patient with hereditary hemorrhagic telangiectasia (HHT) with epistaxis had variation in bleeding depending on her menstrual cycles.(1) Thus, hormonal therapy was initially used in patients with HHT to control episodes of epistaxis.(2) The literature on hormonal therapy in patients with life-threatening bleeding from gastrointestinal (GI) lesions is very limited. There are a few clinical trials in patients with chronic bleeds. However, no definite guidelines exist on their use in life-threatening GI bleeding in patients with uremia. Here, we describe a case with a life-threatening GI bleeding requiring multiple endoscopies and intensive care unit stay that responded to conjugated estrogens. We have done extensive research on English medical literature on PubMed and Google Scholar on the use of hormonal therapy for GI bleeding in patients with renal failure, and here we present the data as a review.
authors.affiliation: Department of Hematology/Oncology, New York Medical College, Valhalla, NY 10595, USA. gurpreet_lamba@nymc.edu
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Lamba
authors.forename: Harneet
authors.initials: H
authors.lastname: Kaur
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Adapa
authors.forename: Dhaval
authors.initials: D
authors.lastname: Shah
authors.forename: Bharat Kumar
authors.initials: BK
authors.lastname: Malhotra
authors.forename: Shamudheen Mohammed
authors.initials: SM
authors.lastname: Rafiyath
authors.forename: Keyur
authors.initials: K
authors.lastname: Thakar
authors.forename: Ana Cuesta
authors.initials: AC
authors.lastname: Fernandez
mesh_terms: D000368:Aged; D016145:Endoscopy, Digestive System; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000188:drug therapy*
chemical_list: D004966:Estrogens, Conjugated (USP)