Erythropoietin resistance in end-stage renal disease patient with gastric antral vascular ectasia

Lee, Desiree Ji Re; Fragata, Juliana; Pestana, José Osmar Medina; Draibe, Sérgio Antônio; Canziani, María Eugênia Fernandes; Cendoroglo, Miguel; Júnior, Miguel Ângelo de Góes

doi:10.5935/0101-2800.20150042

Cited by 3 publications

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“…However, the absence of the characteristic watermelon appearance does not entirely exclude the presence of GAVE, as the literature review shows that many patients required more than 1 endoscopy to confirm the presence of GAVE. Moreover, 7 cases (22.5%) in the literature review did not report this finding and were diagnosed based on clinical picture [ 12 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Surgical Management of Gastric Antral Vascular Ectasia in a Patient with End-Stage Renal Disease: A Case Report and Literature Review

et al. 2023

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Patient: Female, 54-year-old Final Diagnosis: Gastric antral vascular ectasia Symptoms: Anemia Clinical Procedure: Endoscopic argon plasma coagulation • laparoscopic subtotal gastrectomy Specialty: Gastroenterology and Hepatology • Surgery Objective: Unknown etiology Background: Gastric antral vascular ectasia (GAVE) is a rare clinical entity that presents with acute upper-gastrointestinal bleeding or chronic anemia. It is characterized by endoscopic watermelon appearance of the stomach. It is usually associated with other comorbidities; however, few articles have previously described GAVE in patients with end-stage renal disease. Its management is controversial, and endoscopic management is considered the treatment of choice. Case Report: A middle-age female patient, on regular hemodialysis for ESRD, was referred to the surgical out-patient clinic as a refractory GAVE after failure of endoscopic management as she became blood transfusion-dependent. She underwent laparoscopic subtotal gastrectomy with a Billroth II reconstruction of gastrojejunostomy. She had a smooth postoperative course and was followed up in the clinic for 12 months with no complications. Her hemoglobin level was stable at 9.4 g/dL without further blood transfusion. Conclusions: Gastric antral vascular ectasia is usually associated with other comorbidities; however, an association between GAVE and CKD is rare. Its management is controversial, and endoscopic management is considered the preferred method of treatment. Laparoscopic subtotal gastrectomy is an effective management modality for GAVE, with dramatic improvement and good outcomes in terms of bleeding, blood transfusion requirements, and nutritional status.

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Section: Discussionmentioning

confidence: 99%

Successful Surgical Management of Gastric Antral Vascular Ectasia in a Patient with End-Stage Renal Disease: A Case Report and Literature Review

et al. 2023

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“…Tai ypač svarbu nepavykus iš-gydyti anemijos geležies preparatais arba eritropoetinu, nes kraujuojant iš ektazijų, greitai netenkama geležies atsargų [4]. Fuccio ir kt.…”

Section: Atvejo Aptarimasunclassified

Skrandžio Urvo Kraujagyslių Ektazija Ir Lėtinė Inkstų Liga: Klinikinis Atvejis

Lavinskas

Jucaitis²,

Miglinas

et al. 2017

Medicinos Teorija Ir Praktika

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SANTRAUKAReikšminiai žodžiai: skrandžio urvo kraujagyslių ektazija, lėtinė inkstų liga, dializė. Skrandžio urvo kraujagyslių ektazija yra reta polietiologinė skrandžio gleivinės ir kraujagyslių patologija, neretai sukelianti gyvybei pavojingą kraujavimą. Ši liga dažnai pasitaiko pacientams, sergantiems sistemine skleroze, kepenų ciroze ar Sjogreno sindromu. Pastebėta, jog sergantieji lėtine inkstų liga dažniau susiduria su kraujavimu dėl skrandžio urvo kraujagyslių ektazijos. Šiame straipsnyje aprašomas klinikinis atvejis apie 66 metų pacientę, sergančią 5 stadijos lėtine inkstų liga bei skrandžio urvo kraujagyslių ektazija. Per vienerius metus pacientei dėl kraujavimo iš kraujagyslių ektazijų atliktos 4 argono plazmos koaguliacijos. Nepaisant hemodializių, pacientei atsinaujindavo kraujavimas iš viršutinio virškinamojo trakto. ABSTRACTKey words: gastric antral vascular ectasia, chronic kidney disease, dialysis. Gastric antral vascular ectasia is recognised as a rare cause of upper gastrointestinal bleeding. Gastric antral vascular ectasia is often found in patients with systemic sclerosis, cirrhosis of the liver or Sjogren's syndrome. Additionally, it was observed that patients with chronic renal diseases are more tend to have gastric antral vascular ectasia. We present a case of 66 year old woman with stage 5 of chronic renal disease, undergoing dialysis for 3 years and suffering from recurring gastrointestinal bleeding caused by Gastric antral vascular ectasia. The patient was treated with Argon plasma coagulation overall 4 times in 1 year period, the dialysis were proceeded on. Despite of dialysis treatment, the patient suffered from renewed Gastric antral vascular ectasia and upper gastrointestinal bleeding. ĮVADASSkrandžio urvo kraujagyslių ektazija (angl. "Gastric antral vascular ectasia", GAVE) -tai reta skrandžio gleivinės ir kraujagyslių liga, sukelianti ūmų arba lėtinį kraujavimą iš viršutinio virškinamojo trakto. Apskaičiuota, jog skrandžio urvo kraujagyslių ektazija gali lemti net 4 proc. retų kraujavimų iš viršutinio virškinamojo trakto. Statistiškai dažniau skrandžio urvo kraujagyslių ektazija serga vyresnės nei 70 metų moterys [1].Neretai skrandžio urvo kraujagyslių ektazija diagnozuojama pacientams, sergantiems cukriniu diabetu, sistemine skleroze, Sjogreno sindromu, pirmine biliarine ciroze arba Reynauld fenomenu. Manoma, jog skrandžio urvo krauja-

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Clinical study of Shengxuening tablet combined with rHuEPO for the treatment of renal anemia of maintenance hemodialysis patients

Cheng

et al. 2016

Experimental and Therapeutic Medicine

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The aim of the present study was to investigate the clinical effects of Shengxuening tablet (silkworm excrement) combined with recombinant human erythropoietin (rHuEPO) for the treatment of renal anemia of maintenance hemodialysis (MHD) patients. Seventy-two MHD patients with renal anemia were included in the study and randomly divided into the control (n=34) and observation (n=38) groups. Patients in the control group were treated by hypodermic injection of 100–150 U/(kg·w) rHuEPO and patients in the observation group were treated by rHuEPO + 1.0 g t.i.d. p.o. Shengxuening tablet. The two groups were assisted by conventional treatments including iron, folic acid, vitamin B12 and L-carnitine. After 3 and 6 months, improvement of anemia was compared. After 3 months, the hemoglobin, hematocrit, serum ferritin and transferrin saturation levels of the observation group were significantly higher than those of the control group (p<0.05). In addition, C-reactive protein and superoxide dismutase levels of the observation group were significantly lower than those of the control group (p<0.05). After 6 months, indices of the observation group were ameliorated while the improvement of control group was not obvious, and indices of the observation group were significantly higher than those of the control group (p<0.05). Consumption of rHuEPO in the observation group was significantly less than that of the control group, and the total effective rate was significantly higher than that of the control group (p<0.05). In conclusion, Shengxuening tablet combined with rHuEPO was safe and effective for the treatment of renal anemia of MHD patients.

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Erythropoietin resistance in end-stage renal disease patient with gastric antral vascular ectasia

Cited by 3 publications

References 0 publications

Successful Surgical Management of Gastric Antral Vascular Ectasia in a Patient with End-Stage Renal Disease: A Case Report and Literature Review

Successful Surgical Management of Gastric Antral Vascular Ectasia in a Patient with End-Stage Renal Disease: A Case Report and Literature Review

Skrandžio Urvo Kraujagyslių Ektazija Ir Lėtinė Inkstų Liga: Klinikinis Atvejis

Clinical study of Shengxuening tablet combined with rHuEPO for the treatment of renal anemia of maintenance hemodialysis patients

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