title: Bevacizumab and gastrointestinal bleeding in hereditary hemorrhagic telangiectasia.
abstract: We report a case of severe, refractory gastrointestinal (GI) bleeding in a patient with hereditary hemorrhagic telangiectasia (HHT) whose massive transfusion dependence was lifted shortly after treatment with bevacizumab, an anti-vascular endothelial growth factor. The patient's bleeding had been refractory to repeated endoscopic interventions, tranexamic acid, and tamoxifen. However, following treatment with bevacizumab at 5 mg/kg every other week, nearly 300 units of packed red blood cell transfusions were avoided in one year's time. Despite its relatively high cost, bevacizumab may have a more active role in the management of severe GI bleeding in HHT if such remarkable response can be consistently demonstrated.
authors.affiliation: George Ou, Cherry Galorport, Robert Enns, Division of Gastroenterology, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Ou
authors.affiliation: George Ou, Cherry Galorport, Robert Enns, Division of Gastroenterology, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Cherry
authors.initials: C
authors.lastname: Galorport
authors.affiliation: George Ou, Cherry Galorport, Robert Enns, Division of Gastroenterology, Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Enns
keywords: Bevacizumab; Bleeding; Hereditary hemorrhagic telangiectasia; Osler-Weber-Rendu syndrome; Vascular endothelial growth factor