[Watermelon stomach: Chronic renal failure and/or imatinib?]

Area of Science:

• Gastroenterology
• Hematology
• Oncology

Background:

• Gastric antral vascular ectasia (GAVE) syndrome is an uncommon cause of upper gastrointestinal bleeding.
• Diagnosis can be challenging, often confused with portal hypertensive gastropathy, despite different treatment approaches.
• The exact cause of GAVE is unclear, but it is frequently associated with systemic conditions like liver cirrhosis, autoimmune diseases, and chronic kidney failure.

Observation:

• The study presents a case of GAVE syndrome in a patient treated with imatinib mesylate for chronic myeloid leukemia.
• The patient was also undergoing hemodialysis concurrently.
• This observation suggests a potential link between imatinib mesylate and the development of GAVE syndrome.

Findings:

• Argon plasma coagulation is currently the preferred endoscopic treatment for GAVE due to its effectiveness and safety.
• Surgical antrectomy may be required in some cases.
• GAVE syndrome has recently emerged as a novel adverse reaction associated with imatinib mesylate therapy.

Implications:

• This case expands the known spectrum of adverse reactions to imatinib mesylate.
• It underscores the importance of considering GAVE syndrome in patients on imatinib mesylate, especially those with comorbidities like chronic kidney disease.
• Further research is warranted to elucidate the mechanisms underlying imatinib-induced GAVE and to inform clinical management strategies.