title: Successful treatment of refractory midgut bleeding with ocreotide and corticosteroids in a dialysis patient with suspected sarcoidosis.
abstract: We present a case of severe and recurrent small-bowel bleeding, due to multiple intestinal angiodysplasias, in a female patient with chronic renal failure due to suspected sarcoidosis. Over the years, she required numerous admissions and >200 units of blood for symptomatic anaemia. However, following a small-bowel capsule endoscopy that revealed several small-bowel angiectasis, she was treated successfully with octreotide and corticosteroids. Her transfusion requirements and hospital admissions were reduced drastically. Moreover, hypercalcaemia and liver function tests also normalised after treatment and double-balloon enteroscopy confirmed the complete resolution of these angiodysplasias. This case presentation confirms the usefulness of octreotide in the management of small-bowel angiodysplasias in dialysis patients and highlights the additional benefit of corticosteroids in portal hypertension due to suspected sarcoidosis.
authors.affiliation: University Hospital Crosshouse, Kilmarnock, UK.
authors.forename: Nestor
authors.initials: N
authors.lastname: Velasco
authors.affiliation: University Hospital Crosshouse, Kilmarnock, UK.
authors.forename: Toufeeq
authors.initials: T
authors.lastname: Imtiaz
authors.affiliation: University Hospital Crosshouse, Kilmarnock, UK.
authors.forename: Amir Ali
authors.initials: AA
authors.lastname: Shah
authors.affiliation: Royal Infirmary of Edinburgh, Centre of Liver & Digestive Disorders, Edinburgh, UK.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koulaouzidis
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D016888:Angiodysplasia / Q000150:complications; D053704:Capsule Endoscopy; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007421:Intestine, Small; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D012008:Recurrence; D006435:Renal Dialysis; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D005765:Gastrointestinal Agents; D015282:Octreotide