Granulomatous Mastitis With Erythema Nodosum During Pregnancy: A Case Report

Mabuchi, Sayaka; Ohta, Ryuichi; Egawa, Keiko; Narai, Yoko; Sano, Chiaki

doi:10.7759/cureus.24990

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…An association between infection of the granulomatous mammary gland and Corynebacterium spp. has also been reported [7]. The prevalence of Corynebacterium spp.…”

Section: Discussionmentioning

confidence: 88%

Granulomatous Mastitis Occurring during Pregnancy: A Case Report

et al. 2023

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Background and Objectives: Granulomatous mastitis is a benign disease with a clinical presentation similar to that of breast cancer, and is most commonly observed in women of childbearing age. Although it has been suggested that autoimmune diseases are involved in its pathogenesis, no specific treatments have been established. The occurrence of this disease during pregnancy has rarely been reported. We presented the case of a 37-year-old woman who complained of left breast induration at 24 weeks’ gestation. Materials and Methods: She was pregnant and manifested a dichorionic, diamniotic placenta. At 24 weeks of gestation, the patient experienced a sensation of hardness in her left breast. Mastitis was suspected, and she was treated with cephem antibiotics. Simultaneously, she was diagnosed with erythema nodosum in the extremities. As her symptoms did not improve, an incisional drainage was performed. Bacterial cultures were obtained at 31 weeks of gestation, and Corynebacterium kroppenstedtii was detected. Results: An elective cesarean section was performed at 37 weeks of gestation, and the baby was delivered safely. After delivery, a needle biopsy was performed, and the patient was diagnosed with granulomatous mastitis. She was completely cured with prednisolone after weaning. In this case, the patient’s condition was maintained through incision and drainage, as well as antibiotic, anti-inflammatory, and analgesic drugs during pregnancy. This approach was chosen, taking into consideration the potential side effects of steroids. Conclusions: This case suggests that incisional drainage and antibiotic therapy, as well as steroids and surgery, may be considered in the treatment of granulomatous mastitis occurring during pregnancy. This may also be true for management during delivery. After delivery, breastfeeding and steroidal therapy proved to be effective in treating the condition.

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“…An association between infection of the granulomatous mammary gland and Corynebacterium spp. has also been reported [7]. The prevalence of Corynebacterium spp.…”

Section: Discussionmentioning

confidence: 88%

Granulomatous Mastitis Occurring during Pregnancy: A Case Report

et al. 2023

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“…In our case, the development of arthritis in the patient enabled the diagnosis of atlantoaxial subluxation. General physicians must be vigilant in their examination of joints to detect such rare presentations of RA [13].…”

Section: Discussionmentioning

confidence: 99%

Atlantoaxial Subluxation as the Initial Presentation of Rheumatoid Arthritis: A Case Report

Ohta,

Iwasa,

Sano

2024

Cureus

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Rheumatoid arthritis (RA) is known for its diverse manifestations, although atlantoaxial subluxation is a rare complication. This case report sheds light on the complexity of RA diagnosis, especially in the elderly, and emphasizes the significance of primary care in identifying atypical presentations. A 68-year-old male with a history of chronic obstructive pulmonary disease, hypertension, prior traumatic neck spinal injury, and lumbosacral stenosis presented to a rural community hospital with neck pain, bilateral numbness, and arm weakness. Initially diagnosed with degenerative cervical spondylosis, his condition later progressed to include swollen, painful wrists and metacarpophalangeal joints. Diagnostic tests revealed elevated rheumatoid factor and C-reactive protein, and hand X-ray showed bone erosions. An MRI confirmed an atlantoaxial subluxation. He was diagnosed with RA based on the American College of Rheumatology/European League Against Rheumatism 2010 criteria with a score of 7. The patient underwent cervical fusion surgery and rehabilitation, leading to significant functional improvement. This case underscores the importance of a comprehensive diagnostic approach in primary care for elderly patients presenting with non-specific symptoms. It highlights the need for heightened awareness among general practitioners of atypical RA manifestations, such as atlantoaxial subluxation. The case advocates for continued research into early detection and management strategies for such rare presentations to enhance patient outcomes in RA.

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“…(2) Esta teoría sobre la patogenia de la enfermedad podría estar relacionada con los cambios estructurales y funcionales propios del periodo de lactancia materno y una extravasación de las secreciones lácteas desde los lobulillos, provocando estos granulomas como reacción ante cuerpo extraño. (8) Altos niveles de estrógenos y/o progesterona (ya sea a través del embarazo o el uso exógeno) y niveles elevados de prolactina se han postulado en la patogénesis de la mastitis granulomatosa, ya que algunos estudios describen una asociación estadísticamente significativa entre antecedentes de embarazo y lactancia materna con la recurrencia de la MG. (1,9) Otro factor posiblemente relacionado con el aumento de estrógenos es la obesidad, ya que la síntesis de tejido adiposo con la formación de estrógenos podría establecerse como un factor de riesgo añadido.…”

Section: Discussionunclassified

Granulomatous mastitis

Oprisan,

Juan Gimeno,

Rubio Micó

2024

an. ranm

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Granulomatous mastitis is a chronic, benign and inflammatory disease of the breasts from idiopatic etiology. It usually appears in women until 5 years after giving birth. The main hypothesis explains an autoimmune phenomenon as a result of expelled antigens from the breast-feeding period.Its clinical expression varies a lot, ranging from mastitis, fistulas or nodules. Usually it is seen as a hard nodule in any of the breast quadrants.Due to the fact that granulomatous mastitis clinically resembles inflammatory breast cancer, the diagnosis becomes challenging, needing different radiological tests as well as histiopatological samples for the final diagnosis. The treatment is not well established, and the two main options are complete escision of the breast or corticoesteroids with methotrexate. Even with this treatment, in half of cases the disease chronifies.

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Granulomatous Mastitis With Erythema Nodosum During Pregnancy: A Case Report

Cited by 4 publications

References 15 publications

Granulomatous Mastitis Occurring during Pregnancy: A Case Report

Granulomatous Mastitis Occurring during Pregnancy: A Case Report

Atlantoaxial Subluxation as the Initial Presentation of Rheumatoid Arthritis: A Case Report

Granulomatous mastitis

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