title: Simultaneous occurrence of gastric antral vascular ectasia and protein-losing enteropathy in chronic graft-versus-host disease.
abstract: Gastric antral vascular ectasia (GAVE) leading to upper gastrointestinal bleeding is a heterogeneous disorder that is not commonly recognized in hematopoietic stem cell transplantation (HSCT). Protein-losing enteropathy (PLE) is noted as another gastrointestinal complication in the context of chronic graft-versus-host disease (GVHD) after HSCT. The possibility of a relationship between these two distinct gastrointestinal disorders, however, remains obscure. A 6-year-old boy with acute myelogenous leukemia developed severe hematemesis 4 months after myeloablative HSCT from a human leukocyte antigen-matched sibling donor. The diagnosis of GAVE was made by upper endoscopy and histological examination. The patient simultaneously developed frequent diarrhea and significant hypoproteinemia, consistent with a diagnosis of PLE. This co-occurrence of GAVE and PLE against a background of chronic GVHD was successfully treated with cyclosporin A and prednisolone. To our knowledge, this is the first report of GAVE concurrent with PLE following HSCT. The possible association of GAVE and PLE in chronic GVHD is discussed.
authors: Department of Pediatrics, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan.
authors: Masahiro
authors: M
authors: Hirayama
authors: Eiichi
authors: E
authors: Azuma
authors: Atsuko
authors: A
authors: Nakazawa
authors: Shotaro
authors: S
authors: Iwamoto
authors: Hidemi
authors: H
authors: Toyoda
authors: Yoshihiro
authors: Y
authors: Komada
mesh_terms: D001706:Biopsy; D002648:Child; D003106:Colon / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D020252:Gastric Antral Vascular Ectasia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006086:Graft vs Host Disease / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D011504:Protein-Losing Enteropathies / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012709:Serum Albumin / Q000378:metabolism; D013270:Stomach / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D012709:Serum Albumin
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