Improvement of iron-deficiency anemia resulting from gastric antral vascular ectasia in patients with systemic sclerosis: cyclophosphamide versus argon plasma coagulation

El-Hawary, Amr T; Mostafa, Eman; Mohamed, Salem Youssef; Kotb, Lobna

doi:10.4103/ejim.ejim_8_18

Cited by 2 publications

(1 citation statement)

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“…In terms of GAVE treatment, SSc patients in our cohort were treated in accordance with expert recommendations [ 28 ] including PPI and / or H2RA therapy (95.8% and 33.8% respectively), with endoscopic treatment and surgery being reserved for those with refractory severe GAVE (with laser therapy being performed on just over a quarter of patients (25.5%) in our cohort) [ 28 ]. Despite small studies and case series showing a therapeutic effect of cyclophosphamide on GAVE when used for other indications such as ILD or progressive skin disease, our data did not show a benefit with immunosuppressive therapy including cyclophosphamide [ 29 , 30 ]. However, this study did not specifically address the exact indication for cyclophosphamide; its therapeutic duration and /or therapeutic response so we cannot draw any conclusions as to the benefit of cyclophosphamide therapy in management of SSc GAVE.…”

Section: Discussioncontrasting

confidence: 71%

Gastric antral vascular ectasia in systemic sclerosis: a study of its epidemiology, disease characteristics and impact on survival

et al. 2022

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Background To describe the epidemiology, determinants and survival impact of gastric antral vascular ectasia (GAVE) in systemic sclerosis (SSc). Methods Consecutive SSc patients prospectively enrolled in the Australian Scleroderma Cohort Study (ASCS) were included. Univariable and multivariable logistic regression were used to determine the associations of GAVE with clinical manifestations and serological parameters. Kaplan-Meier (K-M) survival curves were used to estimate survival. Results The prevalence of GAVE in this SSc cohort of 2039 SSc patients was 10.6% (n = 216) over a median follow-up period of 4.3(1.7–8.4) years. SSc patients with a history of GAVE compared with those without a history of GAVE were older at SSc onset [49.5 (40.0–58.2) vs 46.7 (36.0–56.7) years, p = 0.05]; more likely to have diffuse disease subtype (dcSSc) (35.3% vs 24.1%, p < 0.001); be negative for Scl-70, U1RNP and Scl/PM antibody (4.0% vs 16.1%, p < 0.001, 3.5% vs 7.4%, p = 0.041, 0.0% vs 2.0%, p = 0.042; and respectively) and positive for RNAP III antibody (24.9% vs 8.3%, p < 0.001). Those with GAVE had a worse HRQoL (p = 0.002). Independent determinants of GAVE included the presence of RNAP III antibody (OR 3.46, p < 0.001), absence of Scl-70 antibody (OR 0.23, p = 0.001), presence of GIT dysmotility (OR 1.64, p = 0.004), and digital ulcers; pits; or digital amputation (OR 1.59, p = 0.014). Conclusions GAVE is an underestimated and underappreciated SSc manifestation of SSc, which occurs with a relatively high frequency. Identifying an at-risk GAVE phenotype, as presented herein, is of practical importance as screening may prove advantageous given GAVE can be easily diagnosed and treated.

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Section: Discussioncontrasting

confidence: 71%

Gastric antral vascular ectasia in systemic sclerosis: a study of its epidemiology, disease characteristics and impact on survival

et al. 2022

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Trace Element Deficiency in Systemic Sclerosis—Too Much Effort for Some Traces?

Opriș-Belinski,

Cobilinschi,

Caraiola

et al. 2024

Nutrients

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Trace elements are essential for several physiological processes. To date, various data have suggested that inadequate levels of trace elements may be involved in the pathogenesis of different chronic diseases, including immune-mediated ones, or may develop during their course. Systemic sclerosis (SSc) is a complex autoimmune multisystemic disease, primarily characterized by microvascular dysregulation, the widespread activation of the immune system and tissue fibrosis. According to the latest reports regarding the pathogenesis of SSc, the main pathophysiological processes—inflammation, vasculopathy and fibrosis—may include various trace element derangements. The present literature review aims to update the available data regarding iron, zinc, copper and selenium status in SSc as well as to underline the possible implications of these trace elements in the complexity of the pathogenic process of the disease. We observe that the status of trace elements in SSc plays a crucial role in numerous pathogenic processes, emphasizing the necessity for proper monitoring and supplementation. The reported data are heterogenous and scarce, and future studies are needed in order to draw clearer conclusions about their complete spectrum.

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Improvement of iron-deficiency anemia resulting from gastric antral vascular ectasia in patients with systemic sclerosis: cyclophosphamide versus argon plasma coagulation

Cited by 2 publications

References 10 publications

Gastric antral vascular ectasia in systemic sclerosis: a study of its epidemiology, disease characteristics and impact on survival

Gastric antral vascular ectasia in systemic sclerosis: a study of its epidemiology, disease characteristics and impact on survival

Trace Element Deficiency in Systemic Sclerosis—Too Much Effort for Some Traces?

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