Watermelon stomach in systemic sclerosis: its incidence and management
Version of Record online: 21 MAY 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 28, Issue 4, pages 412–421, August 2008
How to Cite
MARIE, I., DUCROTTE, P., ANTONIETTI, M., HERVE, S. and LEVESQUE, H. (2008), Watermelon stomach in systemic sclerosis: its incidence and management. Alimentary Pharmacology & Therapeutics, 28: 412–421. doi: 10.1111/j.1365-2036.2008.03739.x
- Issue online: 23 JUL 2008
- Version of Record online: 21 MAY 2008
- Publication data Submitted 10 April 2008 First decision 5 May 2008 Resubmitted 16 May 2008 Accepted 16 May 2008 Epub Accepted Article 21 May 2008
Background To date, there are no large endoscopic studies in systemic sclerosis (SSc), and both prevalence and characteristics of watermelon stomach in SSc have not been determined.
Aims To determine the prevalence, clinical presentation, endoscopic appearance, therapy success and long-term outcome in SSc patients with watermelon stomach and 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 as regards patients’ characteristics, time of watermelon stomach onset, features, therapy and outcome of watermelon stomach.
Results Fifteen 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 anaemia, two other patients experienced gastrointestinal haemorrhage. 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 deterioration of watermelon stomach, eight patients (53.3%) underwent endoscopic procedures. During follow-up, five patients (33.3%) exhibited recurrences of watermelon stomach.
Conclusions Our series indicates that watermelon stomach should be considered when unexplained iron-deficiency anaemia occurs in SSc patients. Moreover, because watermelon stomach may be the first manifestation of SSc, patients with unexplained watermelon stomach should systematically undergo physical examination and autoantibody testing to detect the underlying SSc.