Gastric antral vascular ectasia as a manifestation of liver graft versus host disease responsive to ruxolitinib.

Gastric antral vascular ectasia (GAVE) or 'watermelon stomach' is a rare angio-dysplastic disorder causing gastric bleeding. The aetiology of GAVE is unknown, but it is associated with several conditions including autoimmune disease, chronic renal failure and liver disorders. It can also develop as a complication of haematopoietic stem cell transplantation (HSCT)-GAVE, most associated with conditioning regimens including busulfan. HSCT-GAVE has also been linked with thrombotic microangiopathy and graft versus host disease (GVHD), but the relationship is poorly understood. This report presents a patient status post-allogeneic HSCT who developed severe refractory GAVE, ultimately found to be a manifestation of liver GVHD responsive to treatment with ruxolitinib.