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International Journal of Hematology

, Volume 97, Issue 4, pp 529–534 | Cite as

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

  • Masahiro Hirayama
  • Eiichi AzumaEmail author
  • Atsuko Nakazawa
  • Shotaro Iwamoto
  • Hidemi Toyoda
  • Yoshihiro Komada
Case Report

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.

Keywords

Gastric antral vascular ectasia Protein-losing enteropathy Hematopoietic stem cell transplantation Graft-versus-host disease 

Notes

Acknowledgments

Written informed consent to publication was obtained.

Conflict of interest

There are no conflicts of interest in the all authors.

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Copyright information

© The Japanese Society of Hematology 2013

Authors and Affiliations

  • Masahiro Hirayama
    • 1
  • Eiichi Azuma
    • 2
    Email author
  • Atsuko Nakazawa
    • 3
  • Shotaro Iwamoto
    • 1
  • Hidemi Toyoda
    • 1
  • Yoshihiro Komada
    • 1
  1. 1.Department of PediatricsMie University Graduate School of MedicineTsuJapan
  2. 2.Department of Cell TransplantationMie University Graduate School of MedicineTsuJapan
  3. 3.Department of PathologyNational Center for Child Health and DevelopmentSetagayaJapan

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