A case of gastric antral vascular ectasia--increase of neuroendocrine cells in the antrum.

We report an 82-year-old woman with severe iron deficiency anemia who was found to have gastric antral vascular ectasia (GAVE). As she required repeated blood transfusion for the anemia and did not respond to various medical treatments, she was referred for antrectomy. The pathogenesis of GAVE is still obscure and may involve many factors. In our patient, immunohistochemical studies of the resected stomach disclosed a marked increase of neuroendocrine cells. The majority of these hyperplastic neuroendocrine cells, furthermore, showed immunoreactivity for 5-hydroxytryptamine (serotonin). These findings suggest that neuroendocrine mediators, serotonin in particular, may have been responsible for the local vasodilation.