Gastric antral vascular ectasia in systemic sclerosis: complete resolutionwith methylprednisolone and cyclophosphamide

A case of severe, transfusion dependent anaemia in a 72 year old woman, whi ch on endoscopy was found to be due to gastric antral vascular ectasia (GAV E), is reported. Repeated endoscopic sclerotherapy was ineffective. She sub sequently developed Raynaud's phenomenon and on further investigation was f ound to have classical systemic sclerosis with lung involvement. Treatment with pulses of intravenous methylprednisolone and cyclophosphamide resulted in significant improvement in her pulmonary function tests and skin score. Coincidentally, her haemoglobin stabilised and further endoscopic examinat ions were normal. This is the first report of cyclophosphamide and methylpr ednisolone leading to complete and sustained resolution of GAVE in associat ion with systemic sclerosis.