Gastric antral vascular ectasia in systemic sclerosis: demographics and disease predictors.
OBJECTIVE
To evaluate patients with systemic sclerosis (SSc) who have gastric antral vascular ectasia (GAVE), to further characterize this disease association, and to identify factors that may predict which patients with SSc are at greatest risk for the development of GAVE.


METHODS
Patients with a diagnosis of both SSc and GAVE were identified from the Division of Rheumatology at Georgetown University and Thomas Jefferson University. A chart review was conducted to obtain the demographic data.


RESULTS
Twenty-eight patients were included in this analysis, including 17 with diffuse cutaneous (dcSSc) and 11 with limited cutaneous SSc (lcSSc). The mean disease duration at diagnosis with GAVE was 21.5 months for dcSSc and 84.3 months for lcSSc (p = 0.025). Seventy-six percent of patients with dcSSc developed GAVE within 18 months of first scleroderma symptom onset. Over half of patients with early GAVE also had rapidly progressive cutaneous disease. Only 4% had antitopoisomerase I antibody. Although only 1 patient was tested and had positive RNA polymerase (RNAP) III, RNAP III may be overrepresented in this GAVE population. Mean hematocrit levels were 23.8% in dcSSc and 29% in lcSSc.


CONCLUSIONS
dcSSc is associated with earlier development of GAVE, as well as more severe anemia requiring more therapeutic interventions. Rapid progression of cutaneous disease may suggest earlier development of GAVE. Absence of antitopoisomerase I antibodies and presence of antibodies to RNAP III/speckled antinuclear antibody pattern may be useful to identify the subset of patients with SSc with increased risk for GAVE.
Ingraham
Kristin M
KM
Division of Rheumatology, Georgetown University, Washington, DC, USA.
O'Brien
Marie S
MS
Shenin
Max
M
Derk
Chris T
CT
Steen
Virginia D
VD
D000368:Aged; D000906:Antibodies / Q000097:blood; D004264:DNA Topoisomerases, Type I / Q000276:immunology; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000453:epidemiology*; D006400:Hematocrit; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012320:RNA Polymerase III / Q000276:immunology; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications* / Q000208:ethnology* / Q000276:immunology; D013997:Time Factors; D044465:White People / Q000208:ethnology
D000906:Antibodies; D012320:RNA Polymerase III; D004264:DNA Topoisomerases, Type I