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See Latest ArticlesImprovement of severe systemic sclerosis-associated gastric antral vascular ectasia following immunosuppressive treatment with intravenous cyclophosphamide
Journal of Rheumatology, 08/14/09
Schulz SW et al. – Study demonstrates that intravenous (IV) pulse cyclophosphamide (CYC) immunosuppression was followed by remarkable clinical and endoscopic improvement of systemic sclerosis (SSc)-associated gastric antral vascular ectasia (GAVE).
Methods- Article describe 3 pts with SSc with severe, transfusion-dependent GAVE, refractory to laser ablation who showed remarkable clinical and endoscopic improvement following IV pulse CYC treatment
- Clinical records and upper gastrointestinal endoscopy images before and after treatment with IV pulse CYC were reviewed
- IV CYC was followed by:
- Improvement and stabilization of hemoglobin levels
- Marked reduction in blood transfusion requirements, and
- Number and frequency of endoscopic laser treatments
Schulz, SW and Jimenez, SA, 08/18/09
| "The use of cyclophosphamide has proven useful in the management of certain complications of systemic sclerosis such as pulmonary fibrosis. Thus, the identification in this study of a novel and potentially beneficial effect of the drug is quite important . Patients with GAVE can suffer devastating complications caused by the dilated and tortuous vessels typical of this relatively frequent manifestation of the disease ranging from severe anemia to death from uncontrolled bleeding . For those patients who are refractory to the common first line invasive measures such as YAG laser therapy, cyclophosphamide may provide a viable alternative to stop bleeding and actually reverse the gastric vasculopathy. This report also points out at the possible role of immunological abnormalities in the development of GAVE and suggests that other drugs with immunomodulatory effects may be of benefit in this condition" |
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