LEITE, H. W. S.; LEITE, H.W.S.; http://lattes.cnpq.br/2277803725144981; LEITE, Hagley Walson Soares.; LEITE, Henry Wallace Soares.
Abstract:
Hereditary Hemorrhagic Telangiectasia (HHT) or Osler-Weber-Rendu
Syndrome is a rare systemic fibrovascular dysplasia characterized by spontaneous
and recurrent bleeding. Because it is a pathology of difficult treatment, all therapeutic
modalities are palliative. In this context, further studies on the use of thalidomide in
this hemorrhagic disorder bring a new perspective to improve the quality of life of the
patients. Objectives: To evaluate the therapeutic response and adverse effects of
thalidomide on gastrointestinal bleeding and epistaxis in HHT. Methods: A
bibliographic survey in PUBMED and BVS/BIREME databases, of articles published
between the years 2010 to 2015, in english, spanish, portuguese and italian
languages, using the keywords: "Thalidomide", "Hereditary Hemorrhagic
telangiectasia" and "Osler-Weber-Rendu Syndrome". Results: After performing pre-
selection of the articles by reading titles and abstracts, 12 were selected; of these,
remained in the review 8 articles. Discussion: The studies are generally concordant
about the potential benefits of thalidomide, which has been shown, in patients with
HHT, be effective in reducing the frequency and intensity of nosebleeds and
gastrointestinal bleeding, in improving hematological profile and reduce the need for
blood transfusions, as also noted the worsening of clinical condition and increased
need for blood transfusions after discontinuation of therapy. Conclusion:
Thalidomide appears to be a potential candidate for the treatment of severe epistaxis
associated with HHT unresponsive to conventional therapies and for refractory
gastrointestinal bleeding secondary to angiodysplasia. Future researches are needed
and should be directed to identify the lowest effective dose of thalidomide.
