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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Hung, EW; Mayes, MD; Sharif, R; Assassi, S; Machicao, VI; Hosing, C; St Clair, EW; Furst, DE; Khanna, D; Forman, S; Mineishi, S; Phillips, K; Seibold, JR; Bredeson, C; Csuka, ME; Nash, RA; Wener, MH; Simms, R; Ballen, K; Leclercq, S; Storek, J; Goldmuntz, E; Welch, B; Keyes-Elstein, L; Castina, S; Crofford, LJ; Mcsweeney, P; Sullivan, KM

Published Date

  • April 2013

Published In

Volume / Issue

  • 40 / 4

Start / End Page

  • 455 - 460

PubMed ID

  • 23418384

Pubmed Central ID

  • 23418384

International Standard Serial Number (ISSN)

  • 0315-162X

Digital Object Identifier (DOI)

  • 10.3899/jrheum.121087

Language

  • eng

Conference Location

  • Canada