Upper gastrointestinal bleeding in a patient with Sjögren syndrome.
A 68-year-old female patient with Sjögren syndrome was admitted with asthenia, anorexia and weight loss. On the third day of admission, she developed severe hematemesis. Urgent upper gastrointestinal endoscopy (UGE) showed multiple gastric and duodenal ulcers, some with active bleeding requiring endoscopic therapy. The anatomopathologic examination was compatible with gastric and duodenal infiltration by a diffuse CD20+ large B cell lymphoma with germinal center B cell-like morphology. And the patient was referred for chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone. Although seldom observed, the risk of lymphoma in Sjögren syndrome is up to 44 times higher than the general population and rises 7 years after diagnosis. We present a brief case report with interesting iconography.
Medicina Interna, Hospital de Santa Maria, Portugal.
Margarida
M
Cortes
Gastrenterologia e Hepatologia, Hospital Santa Maria, Portugal.
Samuel
S
Fernandes
Serviço de Reumatologia, Hospital Santa Maria, Portugal.
Vitor
V
Teixeira
Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Portugal.
Luis Carlos
LC
Freitas
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D012859:Sjogren's Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy