Gastric Antral Vascular Ectasia as an Unusual Cause of Iron Deficiency Anemia in Primary Sjögren’s Syndrome

Gastric antral vascular ectasia (GAVE) is a cause of chronic gastrointestinal (GI) bleeding and is commonly associated with autoimmune disorders such as systemic lupus erythematosus and systemic sclerosis. We report an elderly woman with hypertension and hypothyroidism who presented with sicca symptoms and features of left parotitis. Evaluation revealed strong antinuclear antibody positivity with a specific anti-Ro-52 profile, and a lip biopsy confirmed chronic sialadenitis, consistent with primary Sjögren’s syndrome (PSS). During evaluation, she was incidentally found to have iron deficiency anemia, prompting upper GI endoscopy, which demonstrated multiple oozing telangiectasias consistent with GAVE. The coexistence of GAVE with iron deficiency anemia in the setting of PSS is rare and clinically noteworthy. The patient underwent endoscopic band ligation for GAVE and was treated with steroids, methotrexate, and hydroxychloroquine for PSS, resulting in improvement of sicca symptoms and normalization of hematological parameters.