Gestational gigantomastia in systemic lupus erythematosus

Abstract

CLINICAL IMAGE Gestational gigantomastia in systemic lupus erythematosus 885 infectious mastitis, she was administered cephalexin (2 g/d) for 10 days, without improvement.On physical examination, at 15 weeks of pregnancy, she had large breasts with a peau d'orange aspect (FIGurE 1), without nodules or nipple discharge, and a chest diameter of 133 cm. The rest of the physical examination was unremarkable. The levels of estradiol, luteinizing hormone, progesterone, prolactin, testosterone, thyrotropin, and T 4 were within the reference ranges. Breast ultrasound showed diffuse thickening of the skin and thickening of the subcutaneous tissue without evidence of organized collection. The patient underwent a deep biopsy of the breasts. Histopathological findings were pseudoangiomatous stromal hyperplasia, apocrine metaplasia, and A 33 -year -old woman was diagnosed with systemic lupus erythematosus (SLE) 9 years earlier, based on clinical findings of photosensitive malar rash, alopecia, arthritis, and the presence of autoantibodies, such as antinuclear antibodies with a titer of 1:160 and a speckled pattern, as well as anti -double stranded DNA, anti-ribonucleoprotein, and anti-Sjögren syndrome A antibodies.The patient was regularly using hydroxychloroquine (400 mg/d), with no signs of disease activity or other comorbidities. She became pregnant, and after 10 weeks, she noticed a rapid diffuse, bilateral, and symmetrical enlargement of her breasts, associated with local pain and hyperemia. Her previous pregnancy 10 years earlier was uneventful. With a presumptive diagnosis of

Idiopathic gigantomastia exacerbated during pregnancy. Its relationship with autoimmunity: A case report

“…Its direct relationship with pregnancy and, in some cases, with puberty, allows us to hypothesize a hormonal etiology. 1 The association of gigantomastia with diverse autoimmune diseases, such as myasthenia gravis, 8 systemic lupus erythematosus, 9 rheumatoid arthritis, 10 autoimmune thyroiditis 11 and the presence of autoantibodies, 12 supports the possibility of a role of autoimmunity. Our patient had autoimmune thyroiditis, autoantibodies and a family history of autoimmunity and presented with 1 crisis of the disease related to pregnancy and 2 unrelated to it, which makes us assume a different condition with purely hormonal effects.…”