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THU0218 Successful treatment of weber christian disease (wcd) with thalidomide in a patient failing multiple other medical therapies

HR Barthel
2001 Speaker abstracts 2001   unpublished
All patient underwent endoscopy to assess the type of gastroscopic lesion and the presence of Helicobacter pylori. Requirements of blood transfusion and surgery were also noted. Results A total 63 (29%) out of 216 patients admitted with upper gastrointestinal haemorrhage were using NSAIDs (60% aspirin, 16% piroxicam, 13% diclofenac, 6% combined and 5% other) during a median of 7.5 days (range 1->100 days). Median patients´age was 65 years (range 18-90). NSAIDs were prescribed for pain relieve
more » ... for pain relieve (75%), platelet anti-aggregation (19%) or both (6%). Indication for prescription was done by rheumathology consultants (0%), general practitioners (25%), other consultants (33%) and self-prescribed (41%). Location of lesions at endoscopy were: esophageal (5%), gastric (35%), duodenal (43%) and, multiple lesions (17%). Helicobacter pylori was present in 28 (70%) out of 40 samples. A total of 44 (70%) patients had at least one risk factor for NSAIDs gastropathy of whom only 2 (4%) were receiving prophylaxis with protein pump inhibitors and 1 (2%) with H2-blockers. NSAIDs gastrointestional haemorrhage accounted for a total of 346 admission days, 40 (63%) patients needed blood transfusion and one (1%) suffered surgery. Conclusion Self-prescription is a common cause of NSAIDs gastrointestinal haemorrhage. Only a minor proportion of patients with risk factors for NSAIDs gastropathy receive appropriate prophylaxis with protein pump inhibitors.
doi:10.1136/annrheumdis-2001.750 fatcat:haxpnj4jmjcwpm7lmrbbjpdr3u