Volume 248, Issue 3 pp. 268-269
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Increased plasma vascular endothelial growth factor levels in patients with angiodysplasia

H. Fujita

H. Fujita

Department of Internal Medicine, Tokyo Metropolitan Bokutou General Hospital, Tokyo, Japan

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M. Momoi

M. Momoi

Department of Internal Medicine, Tokyo Metropolitan Bokutou General Hospital, Tokyo, Japan

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Y. Chuganji

Y. Chuganji

Department of Internal Medicine, Tokyo Metropolitan Bokutou General Hospital, Tokyo, Japan

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J. Tomiyama

J. Tomiyama

Department of Internal Medicine, Tokyo Metropolitan Bokutou General Hospital, Tokyo, Japan

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: H. Fujita, Department of Internal Medicine, Tokyo Metropolitan Bokutou General Hospital, 4-23-15 Koutoubashi, Sumida-ku, Tokyo 130-8575, Japan (fax: 81 3 3633 6173; e-mail: chu@STAGEA.nissan.ne.jp).

D ear S ir, Vascular endothelial growth factor (VEGF) plasma or sera levels are elevated in patients with cancer accompanied by neovascularization. Recently, Junquera et al. reported that vascular endothelial growth factor protein expression was upregulated in endothelial cells in colonic angiodysplasia [1]. Therefore, we measured plasma vascular endothelial growth factor levels in patients with angiodysplasia using an enzyme immunoassay. We experienced four patients with angiodysplasia, who complained of gastrointestinal bleeding in our hospital over the past 2 years ( Table 1). Vascular endothelial growth factor levels in angiodysplasia were greatly increased compared with the levels in normal subjects, but not significantly (P = 0.09); all the cases with angiodysplasia had normal renal function. Cases 1–3 were treated using an endoscopic technique and case 4 was treated by surgery. We performed hormone replacement therapy for case 3 on the basis of the previous report [2], because this case had recurrent bleeding from gastrointestinal angiodysplasia. This treatment consisted of 0.05 mg ethinyloestradiol and 0.5 mg norethisterone daily, given orally. Hormone replacement therapy decreased plasma vascular endothelial growth factor levels from 1690 pg mL–1 to 667 pg mL–1, and decreased episodes of bleeding. In the previous paper, the administration of vascular endothelial growth factor induced the migration of endothelial progenitor cells from the bone marrow and angiogenesis in the ischemic tissues [3]. Although the pathogenesis of angiodysplasia remains unknown, Bolay reported that angiodysplasia might appear due to ischemia of the bowel [4]. These results suggested that increased plasma vascular endothelial growth factor might be an angiogenic factor in the ischemic intestine, resulting in angiodysplasia, and that it might be a possible indicator for hormone replacement therapy.

Table 1. Characteristics in control and angiodysplasic subjects.
Normal subject Angiodysplasis
Case 4 4
Age 66.5 ± 2.6 63.0 ± 4.2
Sex (M/F) 2/2 2/2
VEGF (pg mL–1) 33.5 ± 11.3 703.5 ± 276.6
Portion of angiodysplasia Case 1, stomach
Case 2, colon
Case 3, diffuse *
Case 4, jejunum
  • *Diffuse means stocach; duodenum, jejunum, colon

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