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Diffuse cutaneous systemic sclerosis — SCE Rheumatology MCQ

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HardConnective Tissue DiseasesDiffuse cutaneous systemic sclerosisSCE Rheumatology

A woman with limited cutaneous systemic sclerosis develops iron-deficiency anaemia and recurrent occult gastrointestinal bleeding. Gastroscopy shows longitudinal erythematous stripes radiating through the gastric antrum. What is the diagnosis?

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Correct answer: B — Gastric antral vascular ectasia in systemic sclerosis

The best answer is “Gastric antral vascular ectasia in systemic sclerosis”. The watermelon-stomach appearance of longitudinal antral vascular stripes, chronic blood loss and systemic sclerosis identifies gastric antral vascular ectasia. Portal gastropathy has a different mosaic pattern and requires portal hypertension; ulcer disease, lymphoma and mesenteric vasculitis do not match the endoscopic appearance.

Reference: BSR systemic sclerosis guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC11534099/