New therapies for vascular anomalies of the gastrointestinal tract

被引:7
|
作者
Fox, Victor L. [1 ]
机构
[1] Harvard Med Sch, Gastrointestinal Procedures & Endoscopy Unit, Div Gastroenterol Hepatol & Nutr, Boston Childrens Hosp, 300 Longwood Ave, Boston, MA 02115 USA
关键词
Vascular malformations; Blue rubber bleb nevus syndrome; Hemangioma; Angiogenesis inhibitors; Colonic varices without portal hypertension; Sirolimus; BLEB NEVUS SYNDROME; MULTIFOCAL LYMPHANGIOENDOTHELIOMATOSIS; INFANTILE HEMANGIOMAS; PROPRANOLOL; SIROLIMUS; THROMBOCYTOPENIA; PATIENT;
D O I
10.23736/S0026-4946.18.05207-6
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Vascular anomalies are a morphologically and biologically diverse group of vascular channel abnormalities that are often congenital but may evolve or change over time in the developing child. Classification is based on a combination of physical and biological properties and clinical behavior that differentiate primarily between tumors and malformations and includes a few provisionally unclassified lesions. Anomalies of the gastrointestinal (GI) tract may present clinically with GI bleeding, abdominal pain, high-output cardiac failure, and malabsorption. This review focuses on new therapies for the treatment of GI bleeding. Important new pharmacological therapies include treatment of hemangioma with non-selective and selective beta-antagonist agents, propranolol and atenolol, and treatment of blue rubber bleb nevus syndrome and cutaneo-visceral angiomatosis with thrombocytopenia (also known as multifocal lymphangioendotheliomatosis with thrombocytopenia) with sirolimus, an inhibitor of the mammalian target of rapamycin. Therapeutic endoscopy may offer an effective alternative to bowel resection for colonic varices and other focal vascular anomalies of the GI tract that fail to respond to pharmacological therapy.
引用
收藏
页码:303 / 307
页数:5
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