Why we should continue to publish case reports

摘要

IN THIS ISSUE, we have published a case report by Gutsche and colleagues in which they reported a favorable response to a novel therapy of the frequent and often challenging problem of gastrointestinal (GI) bleeding from arterio-venous malformations (AVMs) in a patient with a continuous-flow left ventricular assist device. After multiple therapeutic approaches had failed, the authors administered hormonal therapy (ethinyl estradiol and norethindrone) on the basis of some reports of favorable effects for AVMs-related GI bleeding in other circumstances, and their patient's bleeding resolved. Hormonal therapy previously has not been reported to have been tried in patients with GI bleeding associated with VADs. While this single anecdotal report does not establish the role of this therapy, and I am skeptical that this therapy will turn out to be effective, I recommended that this case report be published because it is hypothesis-generating and suggests a novel therapy, not previously mentioned in the literature on GI bleeding associated with use of LVADs, which deserves further investigation and more rigorous studies (eg, larger series and ideally, randomized controlled trials, [RCT]).