Gastric antral vascular ectasia and its clinical correlates in patients with early diffuse systemic sclerosis in the SCOT trial

Emily W. Hung, Maureen D. Mayes, Roozbeh Sharif, Shervin Assassi, Victor I. Machicao, Chitra Hosing, E. William St. Clair, Daniel E. Furst, Dinesh Khanna, Stephen Forman, Shin Mineishi, Kristine Phillips, James R. Seibold, Christopher Bredeson, Mary Ellen Csuka, Richard A. Nash, Mark H. Wener, Robert Simms, Karen Ballen, Sharon LeclercqJan Storek, Ellen Goldmuntz, Beverly Welch, Lynette Keyes-Elstein, Sharon Castina, Leslie J. Crofford, Peter McSweeney, Keith M. Sullivan

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43 Scopus citations

Abstract

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. The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)455-460
Number of pages6
JournalJournal of Rheumatology
Volume40
Issue number4
DOIs
StatePublished - Apr 2013

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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