RESUMO
Sorafenib, an oral inhibitor of multiple tyrosine kinase receptors, has been widely used as a standard medical treatment for advanced hepatocellular carcinoma (HCC). Here, we report a 66-year-old male patient who developed gastrointestinal bleeding due to radiation-induced hemorrhagic duodenitis associated with sorafenib treatment. We started oral administration of sorafenib because of the recurrence of HCC with lung metastases. The patient had been treated by radiotherapy for para-aortic lymph node metastases from HCC 4 months before the bleeding. Esophagogastroduodenoscopy (EGD) revealed edematous reddish mucosa with friability and telangiectasia in the second portion of the duodenum. Computed tomography and capsule endoscopy revealed that the hemorrhagic lesions were located in the distal duodenum. After discontinuation of sorafenib, the bleeding disappeared and a follow-up EGD confirmed improvement of duodenitis. Based on these findings, the diagnosis of radiation-induced hemorrhagic duodenitis associated with sorafenib was made.
Assuntos
Antineoplásicos/efeitos adversos , Duodenite/etiologia , Hemorragia Gastrointestinal/etiologia , Niacinamida/análogos & derivados , Compostos de Fenilureia/efeitos adversos , Lesões por Radiação/etiologia , Receptores Proteína Tirosina Quinases/antagonistas & inibidores , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/radioterapia , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/radioterapia , Masculino , Pessoa de Meia-Idade , Niacinamida/efeitos adversos , Radioterapia/efeitos adversos , SorafenibeAssuntos
Duodenite/reabilitação , Gastrite/reabilitação , Terapia com Luz de Baixa Intensidade , Adolescente , Adulto , Doença Crônica , Duodenite/etiologia , Duodenite/patologia , Duodenite/radioterapia , Famotidina/uso terapêutico , Feminino , Gastrite/etiologia , Gastrite/patologia , Gastrite/radioterapia , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Decrease in the frequency and degree of ulcer-like pain and dyspeptic syndromes, tendency toward transition to ulcer disease, increase in the frequency of concomitant disorders of digestive system, and of age-related background diseases, were revealed as a result of the examination of 118 patients with chronic primary gastroduodenitis. Lowered indices for the stomach acid formation, atrophy of gastroduodenal mucosa, general disturbances in bioenergetics occurred more often than not. Restriction in anthacides, use of agents capable of improving microcirculation, reparation, energy exchange, and phytotherapy, are the options recommended.
Assuntos
Duodenite/diagnóstico , Gastrite/diagnóstico , Idoso , Doença Crônica , Diagnóstico Diferencial , Duodenite/tratamento farmacológico , Duodenite/etiologia , Feminino , Mucosa Gástrica/metabolismo , Gastrite/tratamento farmacológico , Gastrite/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
In this prospective study we looked for possible epidemiological and etiological factors in "autonomous" nonspecific duodenitis. Of 136 dyspeptic patients who entered the study, duodenitis was found in 25.6% (94.4% chronic duodenitis and 5.6% isolated active duodenitis). Men predominated with a significant prevalence of 74%; 49% of them had white-collar jobs, but age, psychological factors, and the season of the year played no role. We found that smoking and alcohol and coffee intake bore no relation to duodenitis. Helicobacter pylori (HP) was present in only 17.1% of patients with duodenitis, little different from the 10% prevalence in dyspeptic patients without duodenitis. HP was always associated with gastric metaplasia and inflammatory activity.