Gastric Antral Vascular Ectasia and Its Clinical Correlates in Patients with Early Diffuse Systemic Sclerosis in the SCOT Trial

To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia (GAVE; "watermelon stomach") in early diffuse systemic sclerosis (SSc). Subjects with early, diffuse SSc and evidence of specific internal organ involvement were considered for the Scleroderma:...

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Published in:Journal of rheumatology 2013-04, Vol.40 (4), p.455-460
Main Authors: HUNG, Emily W, MAYES, Maureen D, MINEISHI, Shin, PHILLIPS, Kristine, SEIBOLD, James R, BREDESON, Christopher, CSUKA, Mary Ellen, NASH, Richard A, WENER, Mark H, SIMMS, Robert, BALLEN, Karen, LECLERCQ, Sharon, SHARIF, Roozbeh, STOREK, Jan, GOLDMUNTZ, Ellen, WELCH, Beverly, KEYES-ELSTEIN, Lynette, CASTINA, Sharon, CROFFORD, Leslie J, MCSWEENEY, Peter, SULLIVAN, Keith M, ASSASSI, Shervin, MACHICAO, Victor I, HOSING, Chitra, CLAIR, E. William St, FURST, Daniel E, KHANNA, Dinesh, FORMAN, Stephen
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Diseases of the osteoarticular system
Female
Gastric Antral Vascular Ectasia - complications
Gastric Antral Vascular Ectasia - diagnosis
Gastric Antral Vascular Ectasia - physiopathology
Gastroenterology. Liver. Pancreas. Abdomen
Gastroscopy
Humans
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Scleroderma, Diffuse - complications
Scleroderma, Diffuse - physiopathology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary:To describe the prevalence and clinical correlates of endoscopic gastric antral vascular ectasia (GAVE; "watermelon stomach") in early diffuse systemic sclerosis (SSc). 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. 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). 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.
ISSN:0315-162X
1499-2752
DOI:10.3899/jrheum.121087