Hormonal Management of Hereditary Hemorrhagic Telangiectasia

Koch, Henning; Escher, George C.; Lewis, John S.

doi:10.1001/jama.1952.02930320016006

Cited by 122 publications

(53 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,5,9,10 Estrogens have been applied in the treatment of patients with HHT since the 1950s, but so far, only as a systemic treatment method. In 1952, the effectiveness of these hormones in reducing nasal bleeding was first noted by Koch et al 12 They successfully used estrogen in the form of ethinyl estradiol, which was systemically applied to control epistaxis in both men and women with HHT. Estrogens are thought to prevent severe epistaxis by causing squamous metaplasia, thereby changing the nasal lining from ciliated columnar epithelium to stratified keratinizing squamous epithelium.…”

Section: Resultsmentioning

confidence: 99%

Topical Estrogens Combined with Argon Plasma Coagulation in the Management of Epistaxis in Hereditary Hemorrhagic Telangiectasia

Bergler¹,

Sadick²,

Riedel³

et al. 2002

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

The aim of this study was to assess the value of topically applied estrogens in patients with hereditary hemorrhagic telangiectasia. Twenty-six patients with this disorder were treated with argon plasma coagulation and randomized into 2 groups: group A, which had postoperative application of estriol ointment (n = 14), and group B, which had postoperative application of dexpanthenol ointment (n = 12). Over a period of 12 months, the frequency and intensity of bleeding, the patient's satisfaction, and the success of the treatment were evaluated with a questionnaire. Before the operation, more than 90% of the patients in both groups complained of daily episodes of epistaxis. Twelve months after treatment, the frequency and intensity of bleeding had significantly decreased in group A as compared to group B. Of the patients in group A, 93% were satisfied with the treatment. Of the patients in group B, only 42% were satisfied with the treatment. In both groups, more than 90% of the patients were willing to undergo the same treatment again. The combined treatment approach with argon plasma coagulation and topical estriol enables us to significantly prolong the hemorrhage-free interval.

show abstract

Section: Resultsmentioning

confidence: 99%

Topical Estrogens Combined with Argon Plasma Coagulation in the Management of Epistaxis in Hereditary Hemorrhagic Telangiectasia

Bergler¹,

Sadick²,

Riedel³

et al. 2002

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

show abstract

“…1 Since then, hormonal therapy has been reported in several case reports, series, and a few uncontrolled and controlled studies of GI bleeding. All these publications report either an arrest of bleeding or an increase in hemoglobin for the duration of follow-up and an important reduction of transfusion requirements.…”

Section: Discussionmentioning

confidence: 99%

Use of Conjugated Estrogens in Life-Threatening Gastrointestinal Bleeding in Hemodialysis Patients—A Review

Lamba

Kaur

Adapa

et al. 2012

Clin Appl Thromb Hemost

View full text Add to dashboard Cite

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.

show abstract

“…One such option may be hormonal therapy. Estrogen/progesterone therapy (EPT) was first reported to be of benefit in the treatment of patients with HHT and epistaxis in 1952 [26]. More recently, several investigators have reported a beneficial effect of EPT in patients with recurrent GI bleeding from AVMs [27-321.…”

Section: Discussionmentioning

confidence: 99%

Angiodysplasia and von willebrand's disease type IIB treated with estrogen/progesterone therapy

1992

View full text Add to dashboard Cite

The association between angiodysplasia and von Willebrand's disease was first reported in 1967. The cases reported to date have involved patients with type I and IIA von Willebrand's disease. We report a patient with type IIB von Willebrand's disease who suffered gastrointestinal bleeding attributable to gastric angiodysplasia. The patient underwent endoscopic electrocautery acutely and has been treated long-term with estrogen/progesterone therapy. She has suffered no recurrent gastrointestinal bleeding at over 11 months of follow-up. We suggest hormonal therapy as an alternative to repeated blood product transfusion or extensive surgical resection in patients with von Willebrand's disease and gastrointestinal bleeding from angiodysplasia.

show abstract

Hormonal Management of Hereditary Hemorrhagic Telangiectasia

Cited by 122 publications

References 2 publications

Topical Estrogens Combined with Argon Plasma Coagulation in the Management of Epistaxis in Hereditary Hemorrhagic Telangiectasia

Topical Estrogens Combined with Argon Plasma Coagulation in the Management of Epistaxis in Hereditary Hemorrhagic Telangiectasia

Use of Conjugated Estrogens in Life-Threatening Gastrointestinal Bleeding in Hemodialysis Patients—A Review

Angiodysplasia and von willebrand's disease type IIB treated with estrogen/progesterone therapy

Contact Info

Product

Resources

About