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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Rendu-Osler disease: treatment with oestrogen/progestagen versus octreotide
  1. Séverin Jeanneret1,
  2. Loic Regazzoni2,
  3. Bernard Favrat3
  1. 1CHUV, Rue du Bugnon, Lausanne, Switzerland
  2. 2Consultation Générale, Policlinique Médicale universitaire, Lausanne, Switzerland
  3. 3Policlinique Médicale Universitaire, Lausanne, Switzerland
  1. Correspondence to Dr Loic Regazzoni, loic.regazzoni{at}chuv.ch

Summary

In Rendu-Osler disease, haemorrhages due to gastrointestinal vascular malformations are common. Surgical and endoscopic treatments for haemorrhage due to gastrointestinal vascular malformations are compromised when lesions are diffuse, escape identification or are inaccessible to treatment. Hormonal treatment with oestrogen and progestagens is still controversial based on contradictory results from two randomised clinical trials. Although somatostatin and its long-acting analogue, octreotide, have been reported to be beneficial in preventing rebleeding, there is no consensus on this type of treatment. This case report shows how the combination of ethinyloestradiol and norethisterone markedly reduced the need for blood transfusions with few side effects in one patient; in comparison, octreotide seems less effective but this could be related to a worsening of the disease.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.