Pediatr Gastroenterol Hepatol Nutr.  2018 Jan;21(1):68-71. 10.5223/pghn.2018.21.1.68.

Colonic Angioectasia in an Adolescent Boy with Hoyeraal-Hreidarsson on Long-Term Anabolic Steroid Therapy

• Khalaf R
• Cuffari C

• KMID: 2401775
• DOI: http://doi.org/10.5223/pghn.2018.21.1.68

Abstract

Androgen therapy has proven efficacy in treating patients with bone marrow failure who are not candidates for bone marrow transplantation. Herein, we report on a case of colonic angioectasia secondary to oxymetholone use in an adolescent patient with Hoyeraal-Hreidarsson syndrome (HHS). A 13-year-old Caucasian male with HHS characterized by cerebellar hypoplasia, developmental delay, microcephaly, esophageal strictures and myelodysplasia presented with severe hematochezia from colonic angioectasia secondary to long-term oxymetholone therapy. These vascular lesions resolved spontaneously once this anabolic steroid was discontinued. While androgen therapy is often recommended for certain anemias and myelodysplastic syndromes, clinicians should be aware of the potential complication in developing these perceived uncommon colonic angioectasias. Moreover, pediatric gastroenterologists should familiarize themselves in identifying these vascular lesions by colonoscopy, especially among the high risk groups on long-term anabolic steroid therapy.

Keyword

Hoyeraal-Hreidarsson syndrome; Colon; Angioectasia; Testosterone congeners

MeSH Terms

Adolescent*
Anemia
Bone Marrow
Bone Marrow Transplantation
Colon*
Colonoscopy
Constriction, Pathologic
Gastrointestinal Hemorrhage
Humans
Male*
Microcephaly
Myelodysplastic Syndromes
Oxymetholone
Testosterone Congeners
Oxymetholone
Testosterone Congeners

Figure

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  Fig. 1 (A) Angioectasia at the hepatic flexure, (B) diffuse angioectasias of the ascending colon.

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