A 73-year-old woman with hypertension, arthrosis of both hips, chronic lymphoid leukemia, meningioma of the left cerebellopontine angle operated, hypertensive stenosis® sigmoid colon peritonitis® aortic fibrillation receive segmental cardiopathy.
He had numerous recurrent episodes of gastrointestinal bleeding in the form of melena and rectal bleeding since April 2006.
There were no significant abnormalities in platelet count or function.
Sintrom was withdrawn in September 2006.
Bleedings were: 9 hospital admissions, 4 gastroenterologists, 2 endoscopic capsule examinations and 1 double balloon enteroscopy with oral and anal access.
These endoscopic examinations led to the diagnosis of xanthomas and petechial red spots of the jejunum and ileus also treated with argon, small hyperplastic gastric polyp removed and small ascending colon angiodysplasia.
The patient received subcutaneous methotrexate 0.1 mg every 12 hours, which was not well tolerated.
Hormonal treatment was discarded due to the increased risk of inducing vascular thrombosis due to the patient's lymphoproliferative disease.
Despite medical and medical treatments, up to March 2008 24 endoscopic mucosal consolidations were necessary.
Then, the use of thalidomide at a dose of 300 mg per day was proposed in two doses.
After the evaluation of the patient by physicians and their neurologists, a study with electromyogram and the explanation to the patient of the precaution measures to be taken (in terms of personal use exclusive of thalidomide) Ministry was requested
During the first 2 months of treatment, the patient had occasional rectal bleeding and required transfusion of 3 other concentrates.
In the following 4 months, no new transfusions or admissions due to new episodes of gastrointestinal bleeding were necessary.
Thalidomide has been well established.
Since receiving treatment the patient has had blurred vision due to cataracts and lower limb edemas in relation to her heart disease both unrelated to thalidomide.
