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

Abstract

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.

Diagnostik und Behandlung der hereditären hämorrhagischen Teleangiektasie

“…Aufgrund der für Patientinnen sehr unangenehmen (z. B. Hitzewallungen) und gravierenden Nebenwirkungen (erhöhtes Karzinomrisiko, thromboembolische Komplikationen), ist diese Therapie Einzelfällen vorbehalten, bei denen operative oder andere medikamentöse Maßnahmen nicht möglich sind [26]. Die lokale Therapie mit Gel oder Spray führt ggf.…”

Influence of hormonal changes in patients with hereditary hemorrhagic telangiectasia

“…Numerous different preventive and acute treatment options exist, such as nasal ointments/creams, nasal packing or surgical treatment options like laser treatment or complete closure of the nostrils (5,(8)(9)(10). Medical therapy of epistaxis has been analyzed since long and various preparations have been discussed controversially and tried out with variable success (11).…”