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ACR Image Competition 2022 Results, Part 5

Doron Rimar, MD  |  Issue: April 2023  |  

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.

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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.

About the Contest

The Rheumatology Image Library is a highly accessed teaching resource. The 2022 Image Competition sought images representing a diverse range of patients who show either characteristic or unusual manifestations of rheumatic disease, including systemic sclerosis, localized scleroderma and scleroderma mimics. Look for the Best Overall Image on our website and other regional winners in future issues or in the Rheumatology Image Library.

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