Effectiveness of Methotrexate in Idiopathic Granulomatous Mastitis Treatment

Kehribar, Demet Yalçın; Duran, Tuğba İzci; Polat, Ayfer Kamalı; Özgen, Metin

doi:10.1016/j.amjms.2020.05.029

Cited by 35 publications

(22 citation statements)

References 32 publications

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“…Our study demonstrated that medical treatment is the most prevalent treatment, regardless of whether it is coupled with surgical treatment. Drug therapies have numerous side effects, such as Cushion's syndrome, skin rash, abnormal liver enzymes and abnormal uric acid and [ 46 ]. In our study, 8 (5.3%) patients suffered from skin rash, 11 (7.2%) had abnormal liver enzymes, 3 (2.0%) had abnormal uric acid, and 1 (0.7%) had edema on the lips and face (as shown in Table 3 ).…”

Section: Discussionmentioning

confidence: 99%

A case management model for patients with granulomatous mastitis: a prospective study

et al. 2022

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Background Granulomatous mastitis (GM) is a chronic inflammatory mastitis disease that requires long-term treatment and has a high recurrence rate. Case management has been proven to be an effective mechanism in assisting patients with chronic illness to receive regular and targeted disease monitoring and health care service. The aim of this study was to investigate the application of a hospital-to-community model of case management for granulomatous mastitis and explore the related factors associated with its recurrence. Methods This was a prospective study on patients with granulomatous mastitis based on a case management model. Data on demographic, clinical and laboratory information, treatment methods, follow-up time, and recurrence were collected and analyzed. The eight-item Morisky Medication Adherence Scale (MMAS-8) was used to investigate patients' adherence to medications. Logistic regression models were built for analysis of risk factors for the recurrence of granulomatous mastitis. Results By October 2021, a total of 152 female patients with a mean age of 32 years had undergone the entire case management process. The mean total course of case management was 24.54 (range 15–45) months. Almost all the patients received medication treatment, except for one pregnant patient who received observation therapy, and approximately 53.9% of the patients received medication and surgery. The overall recurrence rate was 11.2%, and “high” medication adherence (RR = 0.428, 95% CI 0.224–0.867, P = 0.015) was significantly associated with a lower rate of recurrence, while the rate of recurrence with a surgical procedure + medication was higher than that with medication alone (RR = 4.128, 95% CI 1.026–16.610, P = 0.046). Conclusion A case management model for patients with granulomatous mastitis was applied to effectively monitor changes in the disease and to identify factors associated with disease recurrence. “Low” medication adherence was a significant risk factor for the recurrence of granulomatous mastitis. Patients treated with medication and surgery were more likely to experience recurrence than those treated with medication alone. The optimal treatment approach should be planned for granulomatous mastitis patients, and patient medication adherence should be of concern to medical staff.

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Section: Discussionmentioning

confidence: 99%

A case management model for patients with granulomatous mastitis: a prospective study

et al. 2022

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“…The proposed treatment regimens include steroids, immunosuppressants, antibiotic therapy, surgical debridement, and watchful waiting. [30][31][32][33] Irrespective of the treatment strategy employed GLM has a high rate of relapse. 34,35 An infectious etiology has long been a leading hypothesis with regard to GLM but the frequent negative microbial cultures 13 and the lack of response to antibiotic therapy 19 has led to some skepticism.…”

Section: Discussionmentioning

confidence: 99%

Detection of Corynebacterium kroppenstedtii in Granulomatous Lobular Mastitis Using Real-Time Polymerase Chain Reaction and Sanger Sequencing on Formalin-Fixed, Paraffin-Embedded Tissues

Tariq

Menon

Fan

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Associations between granulomatous lobular mastitis (GLM) and Corynebacterium kroppenstedtii have been reported since 2002, but large scale studies to assess the actual prevalence of this bacterium in GLM have not been performed. Objective.— To assess the prevalence of C kroppenstedtii in GLM using real-time polymerase chain reaction and Sanger sequencing. Design.— We analyzed formalin-fixed, paraffin-embedded tissues from 67 cases of GLM by sequential DNA amplification and sequencing to assess the rate of C kroppenstedtii detection in GLM. A retrospective analysis including patient demographics, history of pregnancy and lactation, clinical signs and symptoms, radiographic findings, histologic pattern, Gram stain results, and microbial cultures was performed on 67 cases of GLM. In addition, 10 cases of nongranulomatous breast abscess were included as controls. Results.— C kroppenstedtii 16S rRNA SYBR real-time polymerase chain reaction was positive on formalin-fixed, paraffin-embedded tissues from 46 of 67 (68.7%) GLM cases, while all control cases were negative. Among the positive cases, the majority showed features of cystic neutrophilic granulomatous mastitis. Conclusions.— C kroppenstedtii was highly prevalent in GLM cases and was not found to be associated with nongranulomatous breast abscess in our study (P < .001).

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“…These recovery and remission rates are in line with the rates seen in our study. 22 Kehribar et al 23 treated 33 IGM patients with low-dose steroids and 7.5-15 mg/week of MTX. The complete remission rate achieved was 87.8%, and no relapse occurred during the follow-up.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of methotrexate and low-dose steroid therapy in the treatment of idiopathic granulomatous mastitis

Dalbaşı

Akgül²

2021

Adv Clin Exp Med

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Effectiveness of Methotrexate in Idiopathic Granulomatous Mastitis Treatment

Cited by 35 publications

References 32 publications

A case management model for patients with granulomatous mastitis: a prospective study

A case management model for patients with granulomatous mastitis: a prospective study

Detection of Corynebacterium kroppenstedtii in Granulomatous Lobular Mastitis Using Real-Time Polymerase Chain Reaction and Sanger Sequencing on Formalin-Fixed, Paraffin-Embedded Tissues

The effectiveness of methotrexate and low-dose steroid therapy in the treatment of idiopathic granulomatous mastitis

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