Intravenous cyclophosphamide as a therapeutic option for severe refractory gastric antral vascular ectasia in systemic sclerosis

2015 ◽  
Vol 45 (10) ◽  
pp. 1077-1081 ◽  
Author(s):  
D. A. Papachristos ◽  
M. Nikpour ◽  
C. Hair ◽  
W. M. Stevens
Keyword(s):  
Systemic Sclerosis ◽  
Therapeutic Option ◽  
Gastric Antral Vascular Ectasia ◽  
Intravenous Cyclophosphamide ◽  
Vascular Ectasia

scholarly journals Gastric Antral Vascular Ectasia and Its Clinical Correlates in Patients with Early Diffuse Systemic Sclerosis in the SCOT Trial

2013 ◽  
Vol 40 (4) ◽  
pp. 455-460 ◽  
Author(s):  
Emily W. Hung ◽  
Maureen D. Mayes ◽  
Roozbeh Sharif ◽  
Shervin Assassi ◽  
Victor I. Machicao ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Topoisomerase I ◽  
Rna Polymerase Iii ◽  
Negative Association ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Antral Vascular Ectasia ◽  
Clinical Correlates ◽  
Vascular Ectasia ◽  
Diffuse Systemic Sclerosis ◽  
Vascular Ectasias

Objective.To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia (GAVE; “watermelon stomach”) in early diffuse systemic sclerosis (SSc).Methods.Subjects with early, diffuse SSc and evidence of specific internal organ involvement were considered for the Scleroderma: Cyclophosphamide Or Transplant (SCOT) trial. In the screening procedures, all patients underwent upper gastrointestinal endoscopy. Patients were then categorized into those with or without endoscopic evidence of GAVE. Demographic data, clinical disease characteristics, and autoantibody data were compared using Pearson chi-square or Student t tests.Results.Twenty-three of 103 (22.3%) individuals were found to have GAVE on endoscopy. Although not statistically significant, anti-topoisomerase I (anti-Scl70) was detected less frequently among those with GAVE (18.8% vs 44.7%; p = 0.071). Similarly, anti-RNP antibodies (anti-U1 RNP) showed a trend to a negative association with GAVE (0 vs 18.4%; p = 0.066). There was no association between anti-RNA polymerase III and GAVE. Patients with GAVE had significantly more erythema or vascular ectasias in other parts of the stomach (26.1% vs 5.0%; p = 0.003).Conclusion.Endoscopic GAVE was present on screening in almost one-fourth of these highly selected patients with early and severe diffuse SSc. While anti-Scl70 and anti-U1 RNP trended toward a negative association with GAVE, there was no correlation between anti-RNA Pol III and GAVE. Patients with GAVE had a higher frequency of other gastric vascular ectasias outside the antrum, suggesting that GAVE may represent part of the spectrum of the vasculopathy in SSc.

scholarly journals Prevalence, Correlates and Outcomes of Gastric Antral Vascular Ectasia in Systemic Sclerosis: A EUSTAR Case-control Study

2013 ◽  
Vol 41 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Etienne Ghrénassia ◽  
Jérome Avouac ◽  
Dinesh Khanna ◽  
Chris T. Derk ◽  
Oliver Distler ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Rna Polymerase ◽  
Rna Polymerase Iii ◽  
Scleroderma Renal Crisis ◽  
Gastric Antral Vascular Ectasia ◽  
Vascular Ectasia ◽  
Polymerase Iii ◽  
European League Against Rheumatism ◽  
Vascular Phenotype ◽  
Renal Crisis

Objective.To estimate the prevalence, determine the subgroups at risk, and the outcomes of patients with systemic sclerosis (SSc) and gastric antral vascular ectasia (GAVE).Methods.We queried the European League Against Rheumatism Scleroderma Trials and Research (EUSTAR) network for the recruitment of patients with SSc-GAVE. Each case was matched for cutaneous subset and disease duration with 2 controls with SSc recruited from the same center, evaluated at the time the index case made the diagnosis of GAVE. SSc characteristics were recorded at the time GAVE occurred and the last observation was collected to define the outcomes.Results.Forty-nine patients with SSc and GAVE were included (24 with diffuse cutaneous SSc) and compared to 93 controls with SSc. The prevalence of GAVE was estimated at about 1% of patients with SSc. By multivariate analysis, patients with SSc-GAVE more frequently exhibited a diminished (< 75%) DLCO value (OR 12.8; 95% CI 1.9–82.8) despite less frequent pulmonary fibrosis (OR 0.2; 95% CI 0.1–0.6). GAVE was also associated with the presence of anti-RNA-polymerase III antibodies (OR 4.6; 95% CI 1.2–21.1). SSc-GAVE was associated with anemia (82%) requiring blood transfusion (45%). Therapeutic endoscopic procedures were performed in 45% of patients with GAVE. After a median followup of 30 months (range 1–113 months), survival was similar in patients with SSc-GAVE compared to controls, but a higher number of scleroderma renal crisis cases occurred (12% vs 2%; p = 0.01).Conclusion.GAVE is rare and associated with a vascular phenotype, including anti-RNA-polymerase III antibodies, and a high risk of renal crisis. Anemia, usually requiring blood transfusions, is a common complication.

Gastric antral vascular ectasia (GAVE) associated with systemic sclerosis

2008 ◽  
Vol 37 (4) ◽  
pp. 315-316 ◽  
Author(s):  
M. Yamamoto ◽  
H. Takahashi ◽  
J. Akaike ◽  
C. Suzuki ◽  
Y. Naishiro ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Gastric Antral Vascular Ectasia ◽  
Vascular Ectasia

scholarly journals Improvement of Severe Systemic Sclerosis-associated Gastric Antral Vascular Ectasia Following Immunosuppressive Treatment with Intravenous Cyclophosphamide

2009 ◽  
Vol 36 (8) ◽  
pp. 1653-1656 ◽  
Author(s):  
STEFFAN W. SCHULZ ◽  
MARIE O’BRIEN ◽  
MUHAMMAD MAQSOOD ◽  
NORA SANDORFI ◽  
FRANCESCO DEL GALDO ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Immunosuppressive Treatment ◽  
Upper Gastrointestinal Endoscopy ◽  
Gastric Antral Vascular Ectasia ◽  
Vascular Ectasia ◽  
Transfusion Requirements ◽  
Before And After ◽  
Laser Treatments ◽  
Clinical Records ◽  
Upper Gastrointestinal

Objective.We describe 3 patients with systemic sclerosis (SSc) with severe, transfusion-dependent gastric antral vascular ectasia (GAVE) refractory to laser ablation who showed remarkable clinical and endoscopic improvement following intravenous (IV) pulse cyclophosphamide (CYC) treatment.Methods.Review of clinical records and upper gastrointestinal endoscopy images from 3 patients with SSc and severe GAVE before and after treatment with IV pulse CYC.Results.IV CYC was followed by improvement and stabilization of hemoglobin levels, and marked reduction in blood transfusion requirements and the number and frequency of endoscopic laser treatments.Conclusion.IV pulse CYC immunosuppression was followed by remarkable clinical and endoscopic improvement of SSc-associated GAVE.

scholarly journals Gastric antral vascular ectasia in systemic sclerosis: Association with anti-RNA polymerase III and negative anti-nuclear antibodies

2020 ◽  
Vol 50 (5) ◽  
pp. 938-942
Author(s):  
Naomi Serling-Boyd ◽  
Melody Pei-Shien Chung ◽  
Shufeng Li ◽  
Laren Becker ◽  
Nielsen Fernandez-Becker ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Rna Polymerase ◽  
Rna Polymerase Iii ◽  
Gastric Antral Vascular Ectasia ◽  
Vascular Ectasia ◽  
Polymerase Iii

scholarly journals Clinical images: Gastric antral vascular ectasia in systemic sclerosis

2010 ◽  
Vol 62 (1) ◽  
pp. 290-290 ◽  
Author(s):  
Rene Thonhofer ◽  
Cornelia Siegel ◽  
Markus Trummer ◽  
Alexander Gugl
Keyword(s):  
Systemic Sclerosis ◽  
Gastric Antral Vascular Ectasia ◽  
Clinical Images ◽  
Vascular Ectasia
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