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

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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.

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Acknowledgments

Written informed consent to publication was obtained.

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There are no conflicts of interest in the all authors.

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Authors and Affiliations

  1. Department of Pediatrics, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Masahiro Hirayama, Shotaro Iwamoto, Hidemi Toyoda & Yoshihiro Komada

  2. Department of Cell Transplantation, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Eiichi Azuma

  3. Department of Pathology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan

    Atsuko Nakazawa

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  1. Masahiro Hirayama
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  2. Eiichi Azuma
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  3. Atsuko Nakazawa
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  4. Shotaro Iwamoto
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  5. Hidemi Toyoda
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  6. Yoshihiro Komada
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Correspondence to Eiichi Azuma.

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Hirayama, M., Azuma, E., Nakazawa, A. et al. Simultaneous occurrence of gastric antral vascular ectasia and protein-losing enteropathy in chronic graft-versus-host disease. Int J Hematol 97, 529–534 (2013). https://doi.org/10.1007/s12185-013-1279-y

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  • DOI: https://doi.org/10.1007/s12185-013-1279-y

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