Reminder of important clinical lesson
Analgesics are not always the culprits: isolated gastric fundal varices as the cause of recurrent upper GI bleed in a patient with SLE, rheumatoid arthritis and polymyositis overlap syndrome
1 Hera General Hospital, Medicine, 4a/201, Hera General, Hospital, Makkah, Western, 21955, Saudi Arabia
2 Hera General Hospital, Hera General Hospital, Makkah, 21955, Saudi Arabia
3 Umul Qurah University, Umul Qurah University, Makkah, 21955, Saudi Arabia
Correspondence to:
Abdul Majid Wani, dr_wani_majid{at}yahoo.co.in
The most common cause of upper gastrointestinal bleeding in patients with systemic rheumatic diseases is non-steroidal drug use; this is the case with COX-2 inhibitors, especially when used concomitantly with corticosteroids. Bleeding from varices is unusual in the absence of liver disease. We present an interesting case of a patient with systemic lupus erythematosus, rheumatoid arthritis and polymyositis overlap syndrome with recurrent upper gastrointestinal bleeds from isolated fundal gastric varices and a normal liver.
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