Abstract
A 82 year-old female was admitted because of severe anemia. She has been suffered from aortic stenosis and chronic liver dysfunction. Macrocytic anemia was found with decreased value of serum Vit. B 12 and positive anti-intrinstic factor antibody. Endoscopic congo-red test disclosed achlorhydria. In addition, hypergastrinemia (12, 800 pg/ml), which was not responsive to secretin test, was noted. Marked diffuse vascular ectasia in the antrum of the stomach was found on endospy. Biopsy specimens taken from those areas showed numerous small dilated vessels in the proper mucosal layer, of which findings were compatible with GAVE. The patient was conservatively treated due to aging and multiple risk factors. After continuing massive transfusion for a long time, she had died of multiple organ failure. Fifty cases of GAVE have been reported as far as we know. In Japan, only 2 cases have been reported including our case, Aged female was predominant in GAVE. Mean age was 68.4 years and male-female ratio was 1 to 4. Many cases of GAVE also have achlorhydria (18 cases in 19 evaluated cases) and liver cirrhosis (14 cases in 50 cases). Several cases have aortic stenosis, PSS, and chronic renal failure, respectively. It was known that those diseases can induce vascular ectasia of the gastrointestinal tract. We discussed on the pathogenesis for the developing of GAVE, including its relation to achlorhydria.
