Bevacizumab Results in Ongoing Resolution of Bleeding From Gastrointestinal Arteriovenous Malformations After Treatment Discontinuation

Abstract

Angiodysplasias cause gastrointestinal (GI) bleeding in patients with end-stage renal disease (ESRD). We present a novel case of a 62-year-old man with a history of recurrent GI bleeding requiring multiple transfusions secondary to angiodysplasias in the stomach, duodenum, and small bowel. Therapeutic endoscopic treatments were ineffective and, in total, required 40 units of packed red blood cells in 1 year. He was treated with bevacizumab and achieved a dramatic response of being transfusion free after the first dose. While various treatments for bleeding angiodysplasias exist, refractory cases require innovative approaches. Our case illustrates the successful use of bevacizumab in managing transfusion-dependent anemia secondary to angiodysplasias in ESRD.