Successful Treatment of Intractable Bleeding Caused by Radiation-Induced Hemorrhagic Gastritis Using Oral Prednisolone: A Case Report

Yun, Hyong Geun; Kim, Hong Yong; Kim, Do Yeun; Lim, Yun Jeong

doi:10.4143/crt.2013.114

Cited by 13 publications

(12 citation statements)

References 12 publications

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“…This type of autoimmune disease is common for clinical tumor treatment in which the stomach is within the field of radiotherapy. Gastritis typically appears after the gastric exposure to doses higher than 40–50 Gy [ 96 ]. Although the molecular mechanisms of gastritis following exposure to radiation have not been completely determined, several studies have reported that the suppression of inflammation using anti-inflammatory drugs can help control this condition [ 97 – 99 ].…”

Section: Evidence Of Ir-induced Autoimmune Diseasesmentioning

confidence: 99%

Radiation-induced inflammation and autoimmune diseases

et al. 2018

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Currently, ionizing radiation (IR) plays a key role in the agricultural and medical industry, while accidental exposure resulting from leakage of radioactive sources or radiological terrorism is a serious concern. Exposure to IR has various detrimental effects on normal tissues. Although an increased risk of carcinogenesis is the best-known long-term consequence of IR, evidence has shown that other diseases, particularly diseases related to inflammation, are common disorders among irradiated people. Autoimmune disorders are among the various types of immune diseases that have been investigated among exposed people. Thyroid diseases and diabetes are two autoimmune diseases potentially induced by IR. However, the precise mechanisms of IR-induced thyroid diseases and diabetes remain to be elucidated, and several studies have shown that chronic increased levels of inflammatory cytokines after exposure play a pivotal role. Thus, cytokines, including interleukin-1(IL-1), tumor necrosis factor (TNF-α) and interferon gamma (IFN-γ), play a key role in chronic oxidative damage following exposure to IR. Additionally, these cytokines change the secretion of insulin and thyroid-stimulating hormone(TSH). It is likely that the management of inflammation and oxidative damage is one of the best strategies for the amelioration of these diseases after a radiological or nuclear disaster. In the present study, we reviewed the evidence of radiation-induced diabetes and thyroid diseases, as well as the potential roles of inflammatory responses. In addition, we proposed that the mitigation of inflammatory and oxidative damage markers after exposure to IR may reduce the incidence of these diseases among individuals exposed to radiation.

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Section: Evidence Of Ir-induced Autoimmune Diseasesmentioning

confidence: 99%

Radiation-induced inflammation and autoimmune diseases

et al. 2018

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“…Epsilon aminocaproic acid, a fibrinolytic inhibitor which acts by inhibiting plasminogen and antiplasmin activity has also been used [ 8 ]. Initial therapy with oral prednisolone [ 9 ] and rescue therapies like bevacizumab [ 10 ] have also been tried. Shukuwa et al [ 11 ] described a case of hemorrhagic radiation gastritis after being treated for pancreatic cancer managed with APC successfully.…”

Section: Discussionmentioning

confidence: 99%

Upper GI Bleeding Secondary to Radiation Gastritis in a Patient with Preexisting Portal Hypertensive Gastropathy

Madala

Polavarapu

Gurala

et al. 2021

Case Rep Gastroenterol

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We commonly see patients presenting with either portal hypertensive gastropathy (PHG) or radiation gastritis. Radiation-induced hemorrhagic gastritis is an unusual lethal complication postradiation. Patients with preexisting PHG have very friable mucosa that can easily bleed after radiation for cancer treatment. There is an increased risk of bleeding with both entities present together. Our aim is to focus on treatment and possible prevention of gastrointestinal bleeding in patients with preexisting PHG undergoing radiation therapy for newly diagnosed cancer. Several therapies like prednisolone, argon plasma coagulation, laser coagulation have been proposed. There are no set guidelines for treatment. In these patients, if radiation therapy is indicated either for hepatic or gastrointestinal malignancy, it is suggested to premedicate with proton pump inhibitors or sucralfate. We describe a case of 73-year-old female who presented with upper gastrointestinal bleeding. She had liver cirrhosis secondary to nonalcoholic fatty liver disease and diagnosed with pancreatic cancer, for which she received chemoradiation. She was found to have both radiation gastritis and PHG with diffuse erythematous, edematous, congested mucosa with diffuse oozing blood in the antrum making it very challenging to treat.

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“…It manifests as an edematous change in the mucosa and multiple telangiectasias in the irradiated area, resulting in hemorrhage [9]. RT-induced hemorrhagic gastric disease has been reported in a few case reports, most of which were from gastrointestinal malignancy cases [1011121314]. Das et al [10] reported nine cases of gastric bleeding following RT for intrahepatic cholangiocarcinoma and suggested that the risk of RT-related gastric bleeding was most relevant to V 40 and V 50 of the stomach.…”

Section: Discussionmentioning

confidence: 99%

Gastric Complications after Adjuvant Radiotherapy for Breast Cancer

et al. 2019

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PurposeIn some patients who receive adjuvant radiotherapy (RT) for the left breast, the stomach is located inside the RT field. This study investigates the incidence of gastric complications following adjuvant RT for breast cancer using data of the Health Insurance Review and Assessment Service in South Korea.MethodsWe identified 37,966 women who underwent surgery and received adjuvant RT for breast cancer. The cumulative incidence rate of gastric hemorrhage and gastric cancer was calculated and compared for left and right breast cancers.ResultsAmong 37,966 patients, 19,531 (51.4%) and 18,435 (48.6%) had right and left breast cancers, respectively. After a median follow-up duration of 6.3 years, the cumulative incidence of gastric cancer and gastric hemorrhage did not differ between right and left breast cancers (p = 0.414 and p = 0.166, respectively). The multivariable analysis revealed that old age was the only factor associated with the development of gastric cancer (p < 0.001) and gastric hemorrhage (p < 0.001). The incidence of gastric cancer and hemorrhage did not differ between patients who received adjuvant RT for right and left breast cancers.ConclusionIrradiation-related chronic complications of the stomach in patients with breast cancer are minimal. A study with a longer follow-up duration might be needed to assess the risk of gastric cancer.

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Successful Treatment of Intractable Bleeding Caused by Radiation-Induced Hemorrhagic Gastritis Using Oral Prednisolone: A Case Report

Cited by 13 publications

References 12 publications

Radiation-induced inflammation and autoimmune diseases

Radiation-induced inflammation and autoimmune diseases

Upper GI Bleeding Secondary to Radiation Gastritis in a Patient with Preexisting Portal Hypertensive Gastropathy

Gastric Complications after Adjuvant Radiotherapy for Breast Cancer

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