title: Analgesics are not always the culprits: isolated gastric fundal varices as the cause of recurrent upper GI bleed in a patient with SLE, rheumatoid arthritis and polymyositis overlap syndrome.
abstract: The most common cause of upper gastrointestinal bleeding in patients with systemic rheumatic diseases is non-steroidal drug use; this is the case with COX-2 inhibitors, especially when used concomitantly with corticosteroids. Bleeding from varices is unusual in the absence of liver disease. We present an interesting case of a patient with systemic lupus erythematosus, rheumatoid arthritis and polymyositis overlap syndrome with recurrent upper gastrointestinal bleeds from isolated fundal gastric varices and a normal liver.
authors.affiliation: Hera General Hospital, Medicine, 4a/201, Hera General, Hospital, Makkah, Western, 21955, Saudi Arabia.
authors.forename: Abdul Majid
authors.initials: AM
authors.lastname: Wani
authors.forename: Waleed Mohd
authors.initials: WM
authors.lastname: Hussain
authors.forename: Mohamad Ibrahim
authors.initials: MI
authors.lastname: Fatani
authors.forename: Mazen G
authors.initials: MG
authors.lastname: Bafaraj
authors.forename: Khalid
authors.initials: K
authors.lastname: Showkat
authors.forename: Sadia
authors.initials: S
authors.lastname: Hanif
authors.forename: Ahmad
authors.initials: A
authors.lastname: Qadmani
authors.forename: Mubeena
authors.initials: M
authors.lastname: Akhtar
authors.forename: Ghassan Al
authors.initials: GA
authors.lastname: Maimani