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Gastric antral vascular ectasia (GAVE) and hereditary hemorrhagic telangiectasia (HHT): two different conditions, one treatment

  • Sara SantosEmail author
  • Carlos Bernardes
  • Verónica Borges
  • Gonçalo Ramos
Letter to the Editor
  • 30 Downloads

Dear Editor,

Vascular lesions of the digestive tract are among the most frequent causes of gastrointestinal bleeding and iron-deficiency anemia. We write concerning a particular entity—gastric antral vascular ectasia (GAVE)—which is endoscopically characterized by parallel red stripes, angiomatous lesions at the antral mucosal folds, frequently referred to as watermelon stomach. Besides this typical location, it may rarely be found in the cardia, duodenum, jejunum, and rectum. The pathogenesis of this entity is still obscure. However, it is associated with certain comorbidities, such as autoimmune disease, liver cirrhosis, or chronic renal failure [1, 2].

In patients with active hemorrhage or anemia due to chronic bleeding from GAVE, the available evidence favors endoscopic therapy with argon plasma coagulation (APC) or Nd:YAG. Several medical strategies to reduce GI bleeding have been described, namely hormonal therapy, octreotide, tranexamic acid, thalidomide, or prednisolone, none...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Hsu WH, Wang YK, Hsieh MS, et al.: Insights into the management of gastric antral vascular ectasia (watermelon stomach), Therap Adv Gastroenterol. 2018; 14;11:1756283X17747471Google Scholar
  2. 2.
    Alkhormi AM, Memon MY, Alqarawi A (2018) Gastric antral vascular ectasia: a case report and literature review. J Transl Int Med 6(1):47–51CrossRefGoogle Scholar
  3. 3.
    Sebastian S, O'Morain CA, Buckley MJ (2003) Review article: current therapeutic options for gastric antral vascular ectasia. Aliment Pharmacol Ther 18:157–165CrossRefGoogle Scholar
  4. 4.
    Swanson E, Mahgoub A, MacDonald R, Shaukat A (2014) Medical and endoscopic therapies for angiodysplasia and gastric antral vascular ectasia: a systematic review. Clin Gastroenterol Hepatol 12(4):571–582CrossRefGoogle Scholar
  5. 5.
    Barbara G1 De Giorgio R, Salvioli B: Unsuccessful octreotide treatment of the watermelon stomach. J Clin Gastroenterol. 1998; 26(4):345–6CrossRefGoogle Scholar
  6. 6.
    Nardone G, Rocco A, Balzano T, Budillon G (1999) The efficacy of octreotide therapy in chronic bleeding due to vascular abnormalities of the gastrointestinal tract. Aliment Pharmacol Ther 13(11):1429–1436CrossRefGoogle Scholar
  7. 7.
    Garnier-Viougeat N, Rixe O, Paintaud G (2007 Mar) Pharmacokinetics of bevacizumab in haemodialysis. Nephrol Dial Transplant 22(3):975CrossRefGoogle Scholar
  8. 8.
    Epperla N, Hocking W (2015) Blessing for the bleeder: bevacizumab in hereditary hemorrhagic telangiectasia. Clin Med Res 13(1):32–35CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Centro Hospitalar de Lisboa CentralLisbonPortugal

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