Clinical characteristics and predictive factors of erythema nodosum in granulomatous lobular mastitis

Luo, Wei; Xu, Biao; Wang, Lei; Xiang, Lifang; Lai, Milin; Zhang, Xu; Liu, Xiaoyan

doi:10.1111/ajd.13640

Cited by 10 publications

(9 citation statements)

References 23 publications

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“…It may be the result of deposition of immune complexes and cytokines [37]. Reports have showed higher risk of recurrence in patients with erythema nodosum, and corticosteroids are preferred therapy for coexistence of erythema nodosum and GM [35–37]. In accordance with the literature, corticosteroid was preferred for GM patients with nodular erythema.…”

Section: Discussionmentioning

confidence: 91%

Management of Granulomatous Lobular Mastitis and Risk Factors Associated with Recurrence

et al. 2022

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Background Granulomatous lobular mastitis (GM), an inflammatory breast lesion with unknown etiology, is prone to recur. There is no global consensus on the optimal treatment at present. This study was conducted to show our stepby-step systemic procedure and discuss the recurrence risk factors of GM. Methods The medical record database was retrospectively searched for patients with GM treated in our hospital between January 2015 and September 2021. Patients were divided into non-recurrence group (group A) and recurrence group (group B). Demographic and clinical characteristics, treatment and follow-up were collected and analyzed. Results A total of 885 GM patients were included in our study, all of whom received step-by-step systemic management. The mean age was 33.2 ± 5.2 years. There were 760 (85.9%) patients in group A and 125 (14.1%) in group B. Univariate analysis showed that there was no statistically significant difference between the two groups in size of mass, pregnancy, hyperprolactinemia, bacterial cultures, erythema nodosum. Multivariate analysis showed that patients with purulent nipple discharge, skin lesion, bilateral disease and patients who need the combination of surgery and medication to achieve complete remission had higher risk of recurrence. Conclusions We built a step-by-step systemic procedure for GM, and the recurrence rate was 14.1%. Prolactin level and microbiological results are important for the management of GM. Purulent nipple discharge, skin lesion, bilateral disease and patients who need the combination of surgery and medication to achieve complete remission are associated with GM recurrence. Prolonged maintenance therapy may secure a better prognosis.

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Section: Discussionmentioning

confidence: 91%

Management of Granulomatous Lobular Mastitis and Risk Factors Associated with Recurrence

et al. 2022

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Section: Discussionmentioning

confidence: 99%

“…There have been numerous studies to explore the etiopathogenesis of IGM, but the exact etiology is still unknown. Even though autoimmunity has raised great attention, recent studies reported very few cases presenting antinuclear antibody, anti‐ds‐DNA, and/or RF and erythema nodosum with/without arthritis (Altintoprak et al, 2013; Cetin et al, 2020; Erhan et al, 2000; Koksal, 2022; Luo et al, 2021). Despite its unknown etiology, significant clinical remissions have been obtained by using immunomodulatory drugs including steroids and MTX in patients with diffuse IGM (Erozgen et al, 2010; Lei et al, 2017; Ma et al, 2020; Mizrakli et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…Even though the exact etiology of IGM is unknown, autoimmunity may play a major role in pathogenesis (Özel et al, 2012; Wolfrum et al, 2018). The disease may be autoimmune according to the series including patients with erythema nodosum and arthritis published in the literature (Cetin et al, 2020; Luo et al, 2021). However, the exact immunopathology is unknown due to the rare detection of vasculitis and plasma cell infiltration in the histologic examination.…”

Section: Introductionmentioning

confidence: 99%

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Ozone therapy restores immune dysfunction in refractory idiopathic granulomatous mastitis as a novel potential therapeutic approach

Cabıoğlu

Aktaş

Emiroglu

et al. 2022

Cell Biology International

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Immunological dysfunction has been suggested to play a major role in the pathogenesis of idiopathic granulomatous mastitis (IGM). We recently showed that ozone therapy was effective in patients with steroid-resistant IGM. This study assessed alterations in intracellular cytokine expression patterns in different T-lymphocyte subsets after ozone therapy in refractory IGM. Peripheral blood T lymphocyte subsets (CD8 + , CD4 + , CD4 + CD25 + CD127 − ) were analyzed via flowcytometry for intracellular cytokine expressions IFN-γ, TNF-α, IL-10, and TGF-β before and after completion of 4-month systemic ozone therapy. Ozone therapy significantly increased the CD4 + IFN-γ + (p = 0.032), CD4 + TNF-α + (p = 0.028), and the CD8 + TNF-α + (p = 0.012) T cells. In contrast, significant decreases in CD4 + IL-10 + (p = 0.047) and CD8 + IL-10 + T cells (p = 0.022) and CD4 + CD25 + CD127 −//low Treg cells secreting TGF-β (p = 0.005) were found after ozone therapy. When patients were analyzed according to the response to ozone therapy, patients with a complete remission were more likely to have increased CD3 − CD16 + CD56 + natural killer cells (p = 0.0027) and decreased CD19 + B lymphocytes (p = 0.046) following ozone therapy. Our results suggest that ozone therapy stimulated a T-helper-1 response associated with IFN-γ production and downregulation of TGF-β expression in CD4 + CD25 + CD127 − Treg cells. These alterations in the immune system following ozone therapy can improve wound healing and restore immune dysfunction in patients with refractory IGM.

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“…Seasonal fluctuations suggested the possibility of an immunological disease rather than a resectable disease requiring surgical treatment. In addition, patients may have clinical manifestations of systemic inflammatory responses during the course of GLM, such as polyangiitis ( 23 ), erythema nodosum, fever and arthritis ( 24 ). Drugs for the treatment of GLM are currently under investigation.…”

Section: Discussionmentioning

confidence: 99%

Differential expression profiles of miRNA in granulomatous lobular mastitis and identification of possible biomarkers

et al. 2022

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The etiology and pathogenesis of granulomatous lobular mastitis (GLM) remain largely elusive and the expression levels and regulatory roles of microRNAs (miRNAs or miRs) in GLM have remained mostly undetermined. In the present study, the miRNAs that were differentially expressed in breast biopsy samples from patients with GLM and normal tissue adjacent to fibroadenoma were analyzed, a comprehensive differential expression profile of miRNAs was provided and potential biomarkers were screened out. The expression profile of miRNAs was determined by high-throughput sequencing in the tissues of patients with GLM and healthy controls. Significantly differentially expressed miRNAs were screened by threshold setting and cluster analysis and their target genes were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Finally, circulating differentially expressed miRNAs between the GLM and control groups were further analyzed by reverse transcription-quantitative PCR (RT-qPCR). A total of 31,077 miRNAs were detected by high-throughput sequencing. By using the cutoff criteria of |log2 fold change|>2.5 and q<0.001, 13 miRNAs that were indicated to be GLM biomarkers were screened out. The expression levels of these 13 miRNAs in the GLM group were higher than those in the control group. GO and KEGG enrichment analyses suggested that the occurrence and development of GLM may be associated with autoimmune inflammation, metabolism and pathogenic organisms. miR-451a and miR-5571-3p were confirmed to be significantly increased in the serum of patients with GLM compared with their levels in the serum of healthy volunteers, which suggests that they may be used as biomarkers of GLM. To the best of our knowledge, the present study was the first report detailing genome-wide miRNA profiling of patients with GLM compared with controls. The possible targets and pathways of GLM were evaluated by bioinformatics analysis. The present study identified 13 differentially expressed miRNAs with important theoretical significance and potential application. Furthermore, miR-451a and miR-5571-3p were verified by RT-qPCR as possible biomarkers of GLM.

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Clinical characteristics and predictive factors of erythema nodosum in granulomatous lobular mastitis

Cited by 10 publications

References 23 publications

Management of Granulomatous Lobular Mastitis and Risk Factors Associated with Recurrence

Management of Granulomatous Lobular Mastitis and Risk Factors Associated with Recurrence

Ozone therapy restores immune dysfunction in refractory idiopathic granulomatous mastitis as a novel potential therapeutic approach

Differential expression profiles of miRNA in granulomatous lobular mastitis and identification of possible biomarkers

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