title: Gastric antral vascular ectasia in systemic sclerosis: Where do we stand?
abstract: Gastric antral vascular ectasia (GAVE) continues to be a challenge in both diagnosis and treatment. GAVE has a diverse group of associations and presumed causes, including cirrhosis, chronic renal failure and autoimmune connective tissue diseases. However, in most occasions, the management plan of GAVE itself is the same whatever the underlying disease by using Argon plasma coagulation (APC). Herein, we will discuss three cases of systemic sclerosis-associated GAVE presenting with either acute or chronic gastrointestinal bleeding showing variable responses to APC. Anemia and telangiectasia may be the first striking presentation of systemic sclerosis (SSc). Renal artery stenosis, aortic stenosis, widespread cutaneous and mucosal telangiectasia and hypertension seem to be associated with poor prognosis and should prompt rapid intervention and careful follow-up. Moreover, the hunt for molecular underpinnings of the broad array of vascular lesions in SSc has to include von Willebrand factor and endoglin. Eventually, we will review the recent alternatives that can be effective in SSc-GAVE, such as band ligation, hematopoietic stem cells transplantation and immunotherapy.
authors.affiliation: Rheumatology & Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Hala
authors.initials: H
authors.lastname: El-Gendy
authors.affiliation: Rheumatology & Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Kyrillus S
authors.initials: KS
authors.lastname: Shohdy
authors.affiliation: Rheumatology & Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Gehad G
authors.initials: GG
authors.lastname: Maghraby
authors.affiliation: Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Kerolos
authors.initials: K
authors.lastname: Abadeer
authors.affiliation: Rheumatology & Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Moustafa
authors.initials: M
authors.lastname: Mahmoud
mesh_terms: D000368:Aged; D000740:Anemia / Q000209:etiology; D057908:Argon Plasma Coagulation; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
keywords: argon therapy; cyclophosphamide; gastric antral vascular ectasia; systemic sclerosis; von Willebrand factor