Percutaneous endoscopic gastrostomy in patients with systemic sclerosis

Area of Science:

• Gastroenterology
• Rheumatology
• Internal Medicine

Background:

• Systemic sclerosis (SSc) frequently causes gastrointestinal (GI) dysfunction.
• Severe GI symptoms in SSc can lead to significant malnutrition and underweight, often refractory to dietary interventions.

Observation:

• Two patients with SSc presented with critical underweight (BMI 15 and 17 kg/m²) due to severe GI symptoms.
• Despite previous dietary efforts, substantial weight loss (24 kg and 23 kg) was noted in both patients.

Findings:

• Following percutaneous endoscopic gastrostomy (PEG) insertion, both patients experienced significant weight gain.
• One patient gained 13 kg (BMI to 19 kg/m²) and the other gained 9 kg (BMI to 20 kg/m²) within months.
• Critically low weight was resolved, and quality of life improved for both individuals.

Implications:

• PEG represents a viable therapeutic option for selected SSc patients suffering from severe malnutrition.
• Comprehensive gastrointestinal evaluation prior to PEG is strongly recommended to ensure appropriate patient selection.
• This approach may offer a significant benefit in managing refractory malnutrition in systemic sclerosis.