A case of IgG4-related sclerosing mesenteritis

Nomura, Yoshio; Naito, Yoshiki; Eriguchi, Naofumi; Kume, Toru; Itai, Noriaki; Sonoda, Hironori; Hayashida, Shinsaku; Naito, Shigetoshi; Naito, Hisanori; Yasumoto, Makiko; Akiba, Jun; Kinoshita, Hisafumi; Yano, Hirohisa; Kage, Masayoshi

doi:10.1016/j.prp.2011.05.009

Cited by 39 publications

(23 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, they can sometimes mimic one other. Both diseases rarely co-exist as evidenced by two recent Japanese cases reporting IgG4-related sclerosing mesenteritis [27,28]. Moreover, a recent review on the subject proposes adding sclerosing mesenteritis to the list of diseases associated with IgG4 disorders [29].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution of severe, symptomatic mesocolic panniculitis: a case report

et al. 2012

View full text Add to dashboard Cite

BackgroundMesenteric panniculitis is a rare chronic fibrosing inflammatory disease that typically affects the adipose tissue and mesentery of the small intestine but may also affect the mesosigmoid and the mesocolon. The pathology of this disease remains unclear despite association with some malignancies or inflammatory disorders. We report a case of mesocolic panniculitis and a literature review of its clinical presentation, imaging findings, associated conditions and treatment options.Case presentationA 64 year-old Caucasian man was admitted to the gastroenterology department for severe weakness, left lower quadrant abdominal pain, weight loss and diarrhoea. Physical examination revealed a palpable firm mass occupying the entire left part of the abdomen. Abdominal CT-scan showed fatty infiltration of the mesosigmoid and left mesocolic fat which was strongly suggestive of panniculitis. Laparoscopic surgery revealed an inflamed and edematous mesocolon and mesosigmoid; the sigmoid mucosa appeared petechial which was suggestive of venous ischemia. Histological examination of surgical biopsies revealed mesocolic panniculitis. Despite exhaustive investigation, no associated conditions were found and the cause was classified as idiopathic. Surprisingly, the patient clinically improved without therapeutic intervention other than supportive care.ConclusionAlthough mesenteric panniculitis is most often a radiographic diagnosis without clinical symptomatology, it can also present with significant general status alteration. We report a case of mesocolic panniculitis complicated by development of an inflammatory mass associated with ischemic colitis. Mesenteric panniculitis is a difficult diagnosis to make which typically requires histologic confirmation. The overall prognosis is good with supportive treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution of severe, symptomatic mesocolic panniculitis: a case report

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Although the evidence was insufficient for verification, our patient was also presumed to have, with a relatively high probability, protein-losing enteropathy, according to the serologic, endoscopic and histological findings. In addition, one patient had IgG4-related sclerosing mesenteritis (13). As for the diagnostic method used in each case, 12 patients were diagnosed using CT scans only, 11 patients were diagnosed using open surgical biopsies and 10 patients were diagnosed based on the pathological findings of the surgically removed involved mesentery.…”

Section: Figure 5 the Microscopic Findings Showed Fat Necrosis With mentioning

confidence: 99%

Refractory Sclerosing Mesenteritis Involving the Small Intestinal Mesentery: A Case Report and Literature Review

et al. 2014

View full text Add to dashboard Cite

A 28-year-old Japanese man presented with upper abdominal pain. Computed tomography (CT) revealed a soft tissue mass in the small bowel mesentery. We diagnosed the patient with sclerosing mesenteritis according to the histological findings of small bowel mesentery. Although he was treated with prednisolone, colchicine and azathioprine, neither his symptoms nor CT findings improved. This case is rare in that the disease was refractory. The characteristics of Japanese patients with sclerosing mesenteritis involving small bowel mesentery are not well understood. We herein describe the details of such patients based on a literature review including 32 recently reported Japanese cases.

show abstract

“…The relationship between sclerosing mesenteritis and IgG4‐RD has not been studied well. There have been only a few studies, to our knowledge, on sclerosing mesenteritis and IgG4 in the English literature 7–9 …”

Section: Introductionmentioning

confidence: 99%

IgG4‐related sclerosing mesenteritis: A rare mesenteric disease of unknown etiology

Minato

Shimizu²,

Arano³

et al. 2012

Pathology International

View full text Add to dashboard Cite

Sclerosing mesenteritis is a rare inflammatory and fibrosing disorder of unknown etiology, while IgG4-related disease (IgG4-RD) consists of mass-forming, fibroinflammatory lesions characterized by high serum IgG4 levels and tissue infiltration of many IgG4-positive plasma cells; obliterative phlebitis is common. This report describes a case of sclerosing mesenteritis that was considered a manifestation of IgG4-RD. A 53-year-old man underwent right hemicolectomy because of an ileocecal mass that did not improve with conservative therapy. The ill-defined fibroinflammatory lesion extended in the mesentery with storiform fibrosis, obliterative phlebitis, and infiltration of many IgG4-positive plasma cells. The ratio of IgG4-positive/IgG-positive cells was 64%, and the ratio of forkhead box protein 3 (FOXP3)-positive/CD4-positive cells was elevated (13%). It is likely that at least some cases of sclerosing mesenteritis are a manifestation of IgG4-RD. It is important to investigate this relationship because steroid therapy may benefit such cases.

show abstract

A case of IgG4-related sclerosing mesenteritis

Cited by 39 publications

References 21 publications

Spontaneous resolution of severe, symptomatic mesocolic panniculitis: a case report

Spontaneous resolution of severe, symptomatic mesocolic panniculitis: a case report

Refractory Sclerosing Mesenteritis Involving the Small Intestinal Mesentery: A Case Report and Literature Review

IgG4‐related sclerosing mesenteritis: A rare mesenteric disease of unknown etiology

Contact Info

Product

Resources

About