Complete resolution of gastric antral vascular ectasia after autologous haematopoietic stem cell transplantation in systemic sclerosis

Gastric antral vascular ectasia (GAVE) is a known vascular gastrointestinal (GI) complication of systemic sclerosis (SSc), characterised by an endoscopic appearance, named ‘watermelon stomach’.1 The prevalence of GAVE is as high as 45% in SSc patients with RNA POL III antibodies.1 GAVE carries significant morbidity due to recurrent GI bleeding, requiring blood transfusions and repeated argon plasma coagulation (APC) procedures.2 There is no well-established therapy for GAVE. Autologous haematopoietic stem cell transplantation (AHSCT) is grade A therapy for early diffuse progressive SSc,3 the population at risk for GAVE. During the conditioning period, thrombocytopenia may result in bleeding from active GAVE. In the SCOT trial, patients with active GAVE were excluded from the study and accordingly many centres currently avoid transplanting patients with GAVE.4 AHSCT has been described to improve anaemia in patients with GAVE after AHSCT in one report.
Source: Annals of the Rheumatic Diseases - Category: Rheumatology Authors: Tags: ARD Letter Source Type: research