PubMed · 16196257
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Dennis Drayna. 2005. Founder mutations.. https://doi.org/10.1038/scientificamerican1005-78
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A 64-year-old man with repetitive gastrointestinal bleeding was admitted to our hospital. Colonic artery angiography revealed angiodysplasia as the bleeding site, and echocardiography showed aortic valve stenosis. A decrease in the high molecular weight von Willebrand factor multimers, which are known to play an important role in hemostasis, was observed, and Heyde syndrome was diagnosed. We selected colectomy instead of aortic valve replacement because the patient had undergone two open heart surgeries. Following colectomy, the patient showed a good clinical course without recurrent gastrointestinal bleeding. Colectomy might serve as a therapeutic option for Heyde syndrome after the precise site of angiodysplasia is detected by angiography.
PURPOSE: The safety of high-dose iron sucrose infusion in hospitalized patients with chronic kidney disease was studied. METHODS: A retrospective analysis was conducted at a 478-bed community hospital. A medical informatics search was performed to identify all hospitalized patients who were prescribed i.v. iron sucrose to deliver elemental iron 300 mg every other day for three doses between January and December 2002. Patients were eligible for inclusion in the analysis if they had chronic kidney disease, had an estimated creatinine clearance of <60 mL/min, and were prescribed the above regimen. Information on iron administration, vital signs, hematologic values, and iron indexes was gathered from patients' medical records. Medical record review was also used to identify possible adverse events. RESULTS: A total of 73 patients met eligibility criteria and received a total of 167 doses of iron sucrose. Twenty adverse events were judged as possibly related to iron sucrose administration and included nausea (n = 8 events), reduced blood pressure (n = 4), vomiting (n = 2), dysgeusia (n = 2), constipation (n = 2), fatigue (n = 1), and anxiety (n = 1). The majority of these adverse events were low in severity, as determined by an objective scale. No severe adverse events occurred. There was no association between infusion rate and the occurrence of potential adverse events (p = 0.44). CONCLUSION: Every-other-day i.v. infusion of iron sucrose, to deliver elemental iron 300 mg/dose, was associated with adverse events that were relatively uncommon, minor in severity, and unlikely to require medical intervention.
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