A Case of Mallory-Weiss Syndrome Complicating Pregnancy in a Patient with Scleroderma

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Abstract

The majority of patients with scleroderma have gastrointestinal involvement ¹⁾, and a few experience gastrointestinal hemorrhage, however, gastrointestinal hemorrhage due to Mallory-Weiss syndrome is very rare ^{2,
3)}.

We report upon a 24-year-old pregnant woman with scleroderma who had gastrointestinal hemorrhage due to Mallory-Weiss syndrome.

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Most cited references 12

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Clinical and upper gastrointestinal motility features in systemic sclerosis and related disorders.

M Thumshirn, Heather Wiste, Géraldine Camilleri … (1998)

The aim of this study was to characterize the clinical and motility findings in 62 patients with systemic sclerosis or related disorders referred for evaluation of upper gastrointestinal (GI) symptoms. Methods included retrospective clinical record review and quantitation of esophageal, LES antral, and duodenal motility (3 h fasting, 2 h fed) were compared with results of 10 symptomatic patients with normal gastric emptying. A total of 46 patients had systemic sclerosis, eight mixed connective tissue disease, and eight polymyositis-systemic sclerosis overlap; systemic manifestations were almost invariably present. GI symptoms were: heartburn (77%), nausea/vomiting (58%), dysphagia (61%), diarrhea (53%), constipation (31%), and fecal incontinence (13%). Anatomical studies showed esophageal erosions or GERD (53%), aperistalsis (34%), stricture (29%), and Barrett's metaplasia (16%); megaduodenum, small bowel dilation, or diverticulae (42%); and pneumatosis intestinalis (8%). A total of 36 patients underwent esophageal and 26 esophagogastrointestinal manometry. Postprandial antral motility index was abnormal in 22 of 26; amplitudes and frequency in the antrum (34 +/- 3 mm Hg and 0.6 +/- 0.1/min, respectively) and duodenum (7.3 +/- 0.9 mm Hg and 1.8 +/- 0.5/min) were significantly lower than controls (p < 0.05). In patients with GI symptoms associated with systemic sclerosis and related disorders, the amplitude and frequency of intestinal contractions are typically <10 mm Hg and <2/min. Antral amplitude is low (<40 mm Hg) when antral hypomotility is observed.

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Fertility and pregnancy outcome in women with systemic sclerosis.

V Steen, T Medsger (1999)

To determine fertility and pregnancy outcome in women with systemic sclerosis (SSc; scleroderma) who had disease onset before age 45 years. All living women with scleroderma who had first been evaluated at the University of Pittsburgh Scleroderma Clinic after January 1, 1972 were sent a detailed self-administered questionnaire in 1986 specifically concerning pregnancy outcomes and infertility. This group was compared with 2 race- and age-matched control groups, one comprising women with rheumatoid arthritis (RA) and one comprising healthy neighborhood women identified by random-digit dialing. We determined the number, history, treatment, and outcome of women who either had never been pregnant or had attempted to become pregnant unsuccessfully for more than 1 year. We also obtained data regarding pregnancy outcomes, including the frequency of miscarriage, premature births, small full-term infants, perinatal deaths, and births of live healthy infants. The study group comprised 214 women with SSc, 167 with RA, and 105 neighborhood controls. There were no significant differences in the overall rates of miscarriage, premature births, small full-term births, or neonatal deaths between the 3 groups. Women with SSc were more likely than those without SSc to have adverse outcomes of pregnancy after the onset of their rheumatic disease, particularly premature births (also seen in RA women after disease onset) and small full-term infants. Although a significantly greater number of women with SSc had never been pregnant, there were no significant differences in the frequency of never having been pregnant or of infertility in the 3 groups after adjustment for contributing factors. This study indicates that women with SSc have acceptable pregnancy outcomes compared with those of women with other rheumatic disease and healthy neighborhood controls. Infertility was not a frequent problem. We believe that there are no excessive pregnancy risks to women with SSc or their infants. However, a well-timed pregnancy with careful obstetric monitoring will maximize the likelihood of a successful outcome.

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Gastrointestinal hemorrhage in patients with systemic sclerosis and CREST syndrome.

A Duchini, S Sessoms (1998)

Systemic sclerosis (SSc) and calcinosis, Raynaud's phenomenon, esophageal disease, sclerodactyly, telangiectasia (CREST) syndrome present distinctive microvasculature lesions that are thought to be responsible for tissue damage and disease progression. Involvement of the gastrointestinal tract may lead to the occurrence of profuse hemorrhage. We performed a study to assess the incidence and characteristics of gastrointestinal hemorrhage in a large group of patients with SSc and CREST syndrome.

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Author and article information

Journal

Journal ID (nlm-ta): Korean J Intern Med

Journal ID (iso-abbrev): Korean J. Intern. Med

Title: The Korean Journal of Internal Medicine

Publisher: Korean Association of Internal Medicine

ISSN (Print): 1226-3303

ISSN (Electronic): 2005-6648

Publication date (Print): December 2003

Volume: 18

Issue: 4

Pages: 238-240

Affiliations

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea

Author notes

[* ]Correspondence to : Jung-Yoon Choe, M.D., Department of Internal Medicine, Daegu Catholic University Hospital, 3056-6 Daemyung4-dong, Nam-gu, Daegu, 705-718, Korea Tel : 82-53-650-4027, Fax : 82-53-629-8248, E-mail : jychoe@ 123456cataegu.ac.kr

Article

Publisher ID: kjim-18-4-238-7

DOI: 10.3904/kjim.2003.18.4.238

PMC ID: 4531641

PubMed ID: 14717233

SO-VID: 9dd64c5f-386e-492e-88fb-6cc0c746b44f

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

A Case of Mallory-Weiss Syndrome Complicating Pregnancy in a Patient with Scleroderma

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Abstract

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Most cited references 12

Clinical and upper gastrointestinal motility features in systemic sclerosis and related disorders.

Fertility and pregnancy outcome in women with systemic sclerosis.

Gastrointestinal hemorrhage in patients with systemic sclerosis and CREST syndrome.

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