ACR Image Competition 2022 Results, Part 5

Resolution of GAVE After aHSCT for Progressive Systemic Sclerosis

This image is the Middle East and North Africa regional winner of 2022. (Click to enlarge.)

A 30-year-old man with RNA polymerase III (Pol III)-positive, diffuse, progressive systemic sclerosis had a persistent microcytic anemia with a hemoglobin level of 8 g/dL and evidence of gastric antral ventral ectasia (GAVE) on gastroscopy. He underwent autologous hematopoietic stem cell transplantation (aHSCT). After six months, he achieved a clinical response, his skin improved by 30%, his lung fibrosis resolved, his hemoglobin level increased to 13 g/dL, and on gastroscopy, GAVE resolved completely.

GAVE was considered a contraindication for aHSCT in the SCOT trial (scleroderma: cyclophosphamide or transplantation). However, we suggest patients with GAVE may benefit from aHSCT.

Doron Rimar, MD, is a rheumatologist at Bnai Zion Medical Center, Haifa, Israel. His main focus of research is systemic sclerosis. He is a pioneer in Israel in the treatment of systemic sclerosis with autologous stem cell transplantation.