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
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.


CONCLUSIONS
IV pulse CYC immunosuppression was followed by remarkable clinical and endoscopic improvement of SSc-associated GAVE.
Schulz
Steffan W
SW
Jefferson Institute of Molecular Medicine, Division of Connective Tissue Disease, Department of Dermatology and CutaneousBiology, Division of Rheumatology, Thomas Jefferson University, Philadelphia, Pennsylvania; and Division of Rheumatology, Lehigh ValleyHospital, Allentown, Pennsylvania, USA
O'Brien
Marie
M
Maqsood
Muhammad
M
Sandorfi
Nora
N
Del Galdo
Francesco
F
Jimenez
Sergio A
SA
D001803:Blood Transfusion; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage*; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000188:drug therapy* / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D053685:Laser Therapy; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications* / Q000188:drug therapy*; D012720:Severity of Illness Index
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide