Scleroderma and the watermelon stomach.

Watermelon stomach in systemic sclerosis: its incidence and management

“…Interestingly, we observed that watermelon stomach was an early manifestation in SSc, as it more often occurred in earlier phase of the disease (<5 years after SSc diagnosis). Moreover, progression of watermelon stomach and activity of SSc have rarely been reported previously; the manifestations of watermelon stomach and the activity of SSc did not seem to parallel each other (62.5%) 18–40 . Our findings underline that both watermelon stomach and SSc progressed simultaneously in only 33.3% of patients; in other patients, watermelon stomach occurred when other manifestations of SSc were quiescent.…”

“…Our data underscore that iron‐deficiency anaemia should prompt careful evaluation of SSc patients for the underlying watermelon stomach. In previous cases of SSc patients with GAVE, the median haemoglobin level at watermelon stomach diagnosis was 6.7 g/dL 18–40 . Gastrointestinal bleeding has been described in the form of intermittent melaena/haematemesis in SSc patients with GAVE; in our review, acute overt digestive bleeding occurred in 10.1% of patients, i.e.…”

“…Various clinical presentations may reveal watermelon stomach. In the literature analysis of 77 SSc patients, the initial presentation of watermelon stomach was more commonly recurrent anaemia related to occult gastrointestinal bleeding (90.9% of cases) 18–40 . In our experience, we found that 86.7% of patients presented with iron‐deficiency anaemia.…”

“… 12 have, in fact, noted that 62.2% of patients had autoimmune diseases. Such an association has subsequently been reported rarely in SSc patients 18–41 . Our literature search using the Medline database (1966–2008) indeed identified 77 cases of watermelon stomach in SSc patients; these 77 cases have been reported in 22 articles and one abstract 18–40 .…”

“…The Medline review of 77 cases shows that watermelon stomach was more often diagnosed in patients who were already established as having SSc (80.8%); the median time interval between SSc diagnoses to watermelon stomach onset was 18 months. Both watermelon stomach and SSc were diagnosed concomitantly in other patients (8.2%); in the remaining patients, watermelon stomach preceded the SSc onset (10.9%) 18–40 . This latter finding indicates that because systemic manifestations may precede cutaneous impairment in SSc, when watermelon stomach is diagnosed, an evaluation for SSc (including clinical examination, antinuclear antibodies, nailfold capillaroscopy) should be therefore carried out systematically.…”