Watermelon stomach in systemic sclerosis: its incidence and management.
Posted Sep 11 2009 4:58pm
Research by Marie I and colleagues.
Objective: The aims of this retrospective study were to: 1) determine the prevalence, clinical presentation, endoscopic appearance, therapy success and long-term outcome in systemic sclerosis (SSc) patients with watermelon stomach; and 2) make predictions about which SSc patients are at risk for watermelon stomach.
Patients and Methods: From 1990 to 2008, 264 patients were seen for evaluation of SSc. Data were collected, i.e.: patients' characteristics, time of watermelon stomach onset, features, therapy and outcome of watermelon stomach.
Results: 15 SSc patients (5.7%) exhibited watermelon stomach. SSc onset preceded watermelon stomach manifestations in 13 patients (86.7%). Most patients (86.7%) presented with iron-deficiency anemia, 2 other patients experienced gastrointestinal hemorrhage. Gastroscopy disclosed typical "watermelon stomach" characterized by prominent, erythematous stripes, radiating in a spoke-like fashion from the antrum to the pylorus. All patients received conservative therapy; because of watermelon stomach' deterioration, 8 patients (53.3%) underwent endoscopic procedures. During follow-up, 5 patients (33.3%) exhibited recurrences of watermelon stomach.
Conclusion: Our series indicates that watermelon stomach should be considered when unexplained iron-deficiency anemia occurs in SSc patients. Moreover, because watermelon stomach may be the first manifestation of SSc, patients with unexplained watermelon stomach should undergo systematically physical examination and autoantibody testing, to detect underlying SSc.
Research by Marie I and colleagues.
Objective: The aims of this retrospective study were to: 1) determine the prevalence, clinical presentation, endoscopic appearance, therapy success and long-term outcome in systemic sclerosis (SSc) patients with watermelon stomach; and 2) make predictions about which SSc patients are at risk for watermelon stomach.
Patients and Methods: From 1990 to 2008, 264 patients were seen for evaluation of SSc. Data were collected, i.e.: patients' characteristics, time of watermelon stomach onset, features, therapy and outcome of watermelon stomach.
Results: 15 SSc patients (5.7%) exhibited watermelon stomach. SSc onset preceded watermelon stomach manifestations in 13 patients (86.7%). Most patients (86.7%) presented with iron-deficiency anemia, 2 other patients experienced gastrointestinal hemorrhage. Gastroscopy disclosed typical "watermelon stomach" characterized by prominent, erythematous stripes, radiating in a spoke-like fashion from the antrum to the pylorus. All patients received conservative therapy; because of watermelon stomach' deterioration, 8 patients (53.3%) underwent endoscopic procedures. During follow-up, 5 patients (33.3%) exhibited recurrences of watermelon stomach.
Conclusion: Our series indicates that watermelon stomach should be considered when unexplained iron-deficiency anemia occurs in SSc patients. Moreover, because watermelon stomach may be the first manifestation of SSc, patients with unexplained watermelon stomach should undergo systematically physical examination and autoantibody testing, to detect underlying SSc.