Matsumoto Yuki, Hayashi Haeru, Tahara Koichiro, Yasuda Takuya, Tsubouchi Shoko, Yamamoto Yusuke, Mizuuchi Takahiro, Mori Hiroaki, Sawada Tetsuji
Department of Rheumatology, Tokyo Medical University Hospital, Japan.
Intern Med. 2019 Jan 1;58(1):135-139. doi: 10.2169/internalmedicine.1431-18. Epub 2018 Aug 10.
Gastric antral vascular ectasia (GAVE) is a rare cause of chronic gastric hemorrhaging and iron deficiency anemia and is characterized by a distinctive endoscopic appearance. The main treatment of GAVE is endoscopic; however, medication is necessary in refractory cases. We herein report a 69-year-old woman with systemic sclerosis (SSc) who developed recurrent severe anemia after endoscopic treatment of GAVE that was successfully managed using intravenous cyclophosphamide (IVCY). The recurrence of GAVE after discontinuation of IVCY was successfully managed using a combination of IVCY and endoscopic treatment, without blood transfusion. Long-term IVCY may be indicated for refractory GAVE associated with SSc.
胃窦血管扩张症(GAVE)是慢性胃出血和缺铁性贫血的罕见病因,其特征为独特的内镜表现。GAVE的主要治疗方法是内镜治疗;然而,难治性病例需要药物治疗。我们在此报告一名69岁的系统性硬化症(SSc)女性患者,她在接受GAVE内镜治疗后出现复发性严重贫血,通过静脉注射环磷酰胺(IVCY)成功得到治疗。停用IVCY后GAVE复发,通过IVCY与内镜治疗联合成功控制,无需输血。对于与SSc相关的难治性GAVE,可能需要长期使用IVCY。