Simultaneous occurrence of gastric antral vascular ectasia and protein-losing enteropathy in chronic graft-versus-host disease.

Abstract

Gastric antral vascular ectasia (GAVE) leading to upper gastrointestinal bleeding is a heterogeneous disorder that is not commonly recognized in hematopoietic stem cell transplantation (HSCT). Protein-losing enteropathy (PLE) is noted as another gastrointestinal complication in the context of chronic graft-versus-host disease (GVHD) after HSCT. The possibility of a relationship between these two distinct gastrointestinal disorders, however, remains obscure. A 6-year-old boy with acute myelogenous leukemia developed severe hematemesis 4 months after myeloablative HSCT from a human leukocyte antigen-matched sibling donor. The diagnosis of GAVE was made by upper endoscopy and histological examination. The patient simultaneously developed frequent diarrhea and significant hypoproteinemia, consistent with a diagnosis of PLE. This co-occurrence of GAVE and PLE against a background of chronic GVHD was successfully treated with cyclosporin A and prednisolone. To our knowledge, this is the first report of GAVE concurrent with PLE following HSCT. The possible association of GAVE and PLE in chronic GVHD is discussed.

• Authors: Masahiro Hirayama, Eiichi Azuma, Atsuko Nakazawa, Shotaro Iwamoto, Hidemi Toyoda, Yoshihiro Komada
• Journal: International journal of hematology (Int J Hematol) Vol. 97 Issue 4 Pg. 529-34 (Apr 2013) ISSN: 1865-3774 [Electronic] Japan
• PMID: 23378184 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Serum Albumin

Topics

• Biopsy
• Child
• Colon (pathology)
• Endoscopy, Gastrointestinal
• Gastric Antral Vascular Ectasia (complications, diagnosis, drug therapy)
• Graft vs Host Disease (complications, drug therapy, etiology)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Leukemia, Myeloid, Acute (complications, diagnosis, therapy)
• Male
• Protein-Losing Enteropathies (complications, diagnosis, drug therapy)
• Serum Albumin (metabolism)
• Stomach (pathology)
• Treatment Outcome