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Case Reports in Transplantation
Volume 2018 (2018), Article ID 2376483, 5 pages
https://doi.org/10.1155/2018/2376483
Case Report

HSCT-GAVE as a Manifestation of Chronic Graft versus Host Disease: A Case Report and Review of the Existing Literature

Adult Blood and Marrow Transplant Program, Duke University Medical Center, Durham, NC, USA

Correspondence should be addressed to Mitchell E. Horwitz; ude.ekud@ztiwroh.llehctim

Received 16 October 2017; Revised 5 February 2018; Accepted 8 February 2018; Published 12 March 2018

Academic Editor: Carl Classen

Copyright © 2018 Michael J. Grant and Mitchell E. Horwitz. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastric antral vascular ectasia or “watermelon stomach” is a significant cause of nonvariceal upper GI bleeding and is characterized by red, tortuous ectatic vessels along longitudinal folds in the gastric antrum. The existing literature links GAVE to patients with cirrhosis, scleroderma, bone marrow transplantation, and chronic renal failure among other associations, but its pathophysiology remains ill-defined. Over 30 cases of hematopoietic stem cell transplant-related GAVE (HSCT-GAVE) have been reported in the literature to date and there are likely many more that go undiagnosed or are attributed to another cause of upper gastrointestinal bleeding. Interestingly, a busulfan-containing conditioning regimen has been the primary factor implicated in the etiology of HSCT-GAVE because this was common to all cases in the literature to date. Here, we present the first case of HSCT-GAVE in a patient that was treated with a non-busulfan-containing conditioning regimen. We propose a link between chronic GVHD and the development of HSCT-GAVE that is supported by a similar development of GAVE in patients with systemic sclerosis.