title: Intravenous cyclophosphamide as a therapeutic option for severe refractory gastric antral vascular ectasia in systemic sclerosis.
abstract: Gastric antral vascular ectasia (GAVE) is a rare but important cause of upper gastrointestinal bleeding. It is commonly associated with autoimmune conditions such as systemic sclerosis, and standard treatment involves both supportive measures, as well as endoscopic interventional therapies. While the current therapies are effective for most patients, a few patients develop severe and refractory bleeding. Herein we report two cases of refractory GAVE in patients with diffuse scleroderma, which improved significantly after the administration of intravenous cyclophosphamide. One of these cases is, to our knowledge, the first reported case of cyclophosphamide being used specifically for the treatment of refractory GAVE.
authors.affiliation: Department of Rheumatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
authors.forename: D A
authors.initials: DA
authors.lastname: Papachristos
authors.affiliation: Department of Rheumatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.|Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Nikpour
authors.affiliation: Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia.|Department of Medicine, Deakin University, Geelong, Victoria, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Hair
authors.affiliation: Department of Rheumatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
authors.forename: W M
authors.initials: WM
authors.lastname: Stevens
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D001803:Blood Transfusion; D003520:Cyclophosphamide / Q000008:administration & dosage*; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000188:drug therapy*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D005773:Gastroscopy; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D045743:Scleroderma, Diffuse / Q000150:complications*
chemical_list: D003520:Cyclophosphamide
keywords: cyclophosphamide; gastric antral vascular ectasia; systemic sclerosis