title: [A woman in her 60s with multifactorial  anaemia].
abstract: Anaemia may be multifactorial in origin. We present a woman with  autoimmune hepatitis and secondary warm autoimmune haemolytic anaemia  and most likely also concomitant anaemia of chronic disease. A relapse  of autoimmune haemolysis was successfully treated with steroids  and high-dose intravenous immunoglobulin. At the same time, bleeding  from angiodysplasia in the coecum was masked by unauthorised perorally  administrated iron. No other cause of bleeding was found. During  that period, she required extensive blood transfusions, up to several times  per month. Surgical or endoscopic treatment of the bleeding angiodysplasia  was not possible. Alloimmunisation developed as a complication to  the large number of transfusions, despite the use of steroids. Treatment  with somatostatin analogue markedly reduced the need of our patient  for blood transfusions for a follow-up period of more than one year,  and she has not experienced any side effects. We do not know how  long the haemostasis achieved will last, however, we believe that  this treatment may be an alternative for other patients as bleeding  from angiodysplasia is not uncommon and is often difficult to eradicate.
authors.affiliation: Medisinsk avdeling, Oslo universitetssykehus, Norway. svein.oskar.frigstad@vestreviken.no
authors.forename: Svein-Oskar
authors.initials: SO
authors.lastname: Frigstad
authors.forename: Viggo
authors.initials: V
authors.lastname: Jønsson
authors.forename: Bjørn
authors.initials: B
authors.lastname: Moum
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis*; D001803:Blood Transfusion; D003937:Diagnosis, Differential; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use
chemical_list: D015282:Octreotide