OBJECTIVE: To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia (GAVE; "watermelon stomach") in early diffuse systemic sclerosis (SSc). METHODS: Subjects with early, diffuse SSc and evidence of specific internal organ involvement were considered for the Scleroderma: Cyclophosphamide Or Transplant (SCOT) trial. In the screening procedures, all patients underwent upper gastrointestinal endoscopy. Patients were then categorized into those with or without endoscopic evidence of GAVE. Demographic data, clinical disease characteristics, and autoantibody data were compared using Pearson chi-square or Student t tests. RESULTS: Twenty-three of 103 (22.3%) individuals were found to have GAVE on endoscopy. Although not statistically significant, anti-topoisomerase I (anti-Scl70) was detected less frequently among those with GAVE (18.8% vs 44.7%; p = 0.071). Similarly, anti-RNP antibodies (anti-U1 RNP) showed a trend to a negative association with GAVE (0 vs 18.4%; p = 0.066). There was no association between anti-RNA polymerase III and GAVE. Patients with GAVE had significantly more erythema or vascular ectasias in other parts of the stomach (26.1% vs 5.0%; p = 0.003). CONCLUSION: Endoscopic GAVE was present on screening in almost one-fourth of these highly selected patients with early and severe diffuse SSc. While anti-Scl70 and anti-U1 RNP trended toward a negative association with GAVE, there was no correlation between anti-RNA Pol III and GAVE. Patients with GAVE had a higher frequency of other gastric vascular ectasias outside the antrum, suggesting that GAVE may represent part of the spectrum of the vasculopathy in SSc.
OBJECTIVE: To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia (GAVE; "watermelon stomach") in early diffuse systemic sclerosis (SSc). METHODS: Subjects with early, diffuse SSc and evidence of specific internal organ involvement were considered for the Scleroderma: Cyclophosphamide Or Transplant (SCOT) trial. In the screening procedures, all patients underwent upper gastrointestinal endoscopy. Patients were then categorized into those with or without endoscopic evidence of GAVE. Demographic data, clinical disease characteristics, and autoantibody data were compared using Pearson chi-square or Student t tests. RESULTS: Twenty-three of 103 (22.3%) individuals were found to have GAVE on endoscopy. Although not statistically significant, anti-topoisomerase I (anti-Scl70) was detected less frequently among those with GAVE (18.8% vs 44.7%; p = 0.071). Similarly, anti-RNP antibodies (anti-U1 RNP) showed a trend to a negative association with GAVE (0 vs 18.4%; p = 0.066). There was no association between anti-RNA polymerase III and GAVE. Patients with GAVE had significantly more erythema or vascular ectasias in other parts of the stomach (26.1% vs 5.0%; p = 0.003). CONCLUSION: Endoscopic GAVE was present on screening in almost one-fourth of these highly selected patients with early and severe diffuse SSc. While anti-Scl70 and anti-U1 RNP trended toward a negative association with GAVE, there was no correlation between anti-RNA Pol III and GAVE. Patients with GAVE had a higher frequency of other gastric vascular ectasias outside the antrum, suggesting that GAVE may represent part of the spectrum of the vasculopathy in SSc.
Authors: H Jouanolle; J F Bretagne; M P Ramée; G Lancien; I Le Jean-Colin; D Heresbach; A M Bousser; J Chevrant-Breton; F Joram; J Gastard Journal: Gastroenterol Clin Biol Date: 1989
Authors: Keith M Sullivan; Ellen A Goldmuntz; Lynette Keyes-Elstein; Peter A McSweeney; Ashley Pinckney; Beverly Welch; Maureen D Mayes; Richard A Nash; Leslie J Crofford; Barry Eggleston; Sharon Castina; Linda M Griffith; Julia S Goldstein; Dennis Wallace; Oana Craciunescu; Dinesh Khanna; Rodney J Folz; Jonathan Goldin; E William St Clair; James R Seibold; Kristine Phillips; Shin Mineishi; Robert W Simms; Karen Ballen; Mark H Wener; George E Georges; Shelly Heimfeld; Chitra Hosing; Stephen Forman; Suzanne Kafaja; Richard M Silver; Leroy Griffing; Jan Storek; Sharon LeClercq; Richard Brasington; Mary E Csuka; Christopher Bredeson; Carolyn Keever-Taylor; Robyn T Domsic; M Bashar Kahaleh; Thomas Medsger; Daniel E Furst Journal: N Engl J Med Date: 2018-01-04 Impact factor: 91.245
Authors: Joost F Swart; Eveline M Delemarre; Femke van Wijk; Jaap-Jan Boelens; Jürgen Kuball; Jacob M van Laar; Nico M Wulffraat Journal: Nat Rev Rheumatol Date: 2017-02-23 Impact factor: 20.543