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

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....

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Bibliographic Details
Published in:Journal of rheumatology 2009-08, Vol.36 (8), p.1653-1656
Main Authors: Schulz, Steffan W, O'Brien, Marie, Maqsood, Muhammad, Sandorfi, Nora, Del Galdo, Francesco, Jimenez, Sergio A
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Transfusion
Combined Modality Therapy
Cyclophosphamide - administration & dosage
Diseases of the osteoarticular system
Female
Gastric Antral Vascular Ectasia - drug therapy
Gastric Antral Vascular Ectasia - etiology
Gastric Antral Vascular Ectasia - surgery
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Immunosuppressive Agents - administration & dosage
Infusions, Intravenous
Laser Therapy
Medical sciences
Middle Aged
Other diseases. Semiology
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Scleroderma, Systemic - complications
Scleroderma, Systemic - drug therapy
Severity of Illness Index
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary: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.
ISSN:0315-162X
1499-2752
DOI:10.3899/jrheum.081247