RESUMO
A female patient in her 80s presented with chronic iron-deficiency anaemia secondary to gastric antral vascular ectasia (GAVE), despite repeated endoscopic treatment. Her medical history was notable for chronic myeloid leukaemia, for which she took imatinib. Due to a possible association between imatinib and GAVE described in a small number of case reports, cessation of imatinib was trialled. This led to a significant improvement in the patient's anaemia and resolution of GAVE on repeat endoscopy. GAVE is an uncommon cause of gastrointestinal bleeding, the aetiology of which is uncertain. This report describes an approach to the differential diagnosis of chronic iron-deficiency anaemia and an overview of GAVE syndrome. It illustrates the benefit of broadening the differential when the diagnosis is uncertain and the utility of case reports in informing the differential diagnosis.
Assuntos
Anemia Ferropriva , Antineoplásicos , Ectasia Vascular Gástrica Antral , Mesilato de Imatinib , Leucemia Mielogênica Crônica BCR-ABL Positiva , Feminino , Humanos , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Ectasia Vascular Gástrica Antral/induzido quimicamente , Ectasia Vascular Gástrica Antral/diagnóstico , Ectasia Vascular Gástrica Antral/terapia , Hemorragia Gastrointestinal/etiologia , Mesilato de Imatinib/efeitos adversos , Mesilato de Imatinib/uso terapêutico , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Idoso de 80 Anos ou mais , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêuticoRESUMO
A 23-year-old man presented to the acute assessment unit with acute-onset haematuria within 24 hours of receiving his second dose of the Pfizer-BioNTech COVID-19 vaccine. He had been diagnosed with IgA vasculitis 8 months previously. IgA vasculitis is an autoimmune condition characterised by palpable purpura affecting the lower limbs, abdominal pain, arthralgia and renal disease. He was diagnosed with an acute exacerbation of IgA vasculitis and was discharged with oral prednisolone. Reactivation or first presentation of IgA vasculitis is a rare but increasingly recognised complication of COVID-19 vaccination. This is an important new differential in the assessment of patients with haematuria following COVID-19 vaccination.