Nintedanib-Induced Gastric Antral Vascular Ectasia in Patients With Idiopathic Pulmonary Fibrosis

Gastric antral vascular ectasia (GAVE) is a rare cause of gastrointestinal bleeding. However, its association with nintedanib use, antifibrotic therapy for idiopathic pulmonary fibrosis (IPF), has not been reported. We present 2 cases of GAVE that were presumed to be secondary to nintedanib use in patients with IPF. Both patients experienced anemia, one of which had hematemesis. GAVE diagnosis was confirmed by upper gastrointestinal endoscopy. Moreover, successful treatment was achieved with endoscopic argon plasma coagulation. These cases highlight the importance of considering GAVE as a potential cause of anemia and upper gastrointestinal bleeding in patients with IPF receiving nintedanib.

Automated summary

Gastric antral vascular ectasia (GAVE) is a rare cause of gastrointestinal bleeding. However, its association with nintedanib use, antifibrotic therapy for idiopathic pulmonary fibrosis (IPF), has not been reported. We present 2 cases of GAVE that were presumed to be secondary to nintedanib use in patients with IPF. Both patients experienced anemia, one of which had hematemesis. GAVE diagnosis was confirmed by upper gastrointestinal endoscopy. Moreover, successful treatment was achieved with endoscopic argon plasma coagulation. These cases highlight the importance of considering GAVE as a potential cause of anemia and upper gastrointestinal bleeding in patients with IPF receiving nintedanib.