Mastite granulomateuse idiopathique associée à un érythème noueux

Jacquin-Porretaz, C.; Devalland, Christine; Delapparent, T.; Nardin, Charlée; Dupond, A.-S.

doi:10.1016/j.annder.2019.04.023

Cited by 16 publications

(7 citation statements)

References 35 publications

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“…ROC analysis results in the IGM group showed that the cut-off values for the best sensitivity and specificity for CRP were > 3.625 (94.55% and 70%, respectively). This is consistent with the results of our other study [ 38 ] and those of Jacquin-Porretaz et al [ 39 ]. Contrary to these results, Yigitbasi et al [ 37 ] demonstrated that the CRP levels of the BC group were significantly higher than those of the IGM and control groups.…”

Section: Discussionsupporting

confidence: 94%

Preoperative Fibrinogen and Hematological Indexes in the Differential Diagnosis of Idiopathic Granulomatous Mastitis and Breast Cancer

et al. 2021

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Background and Aim: Studies on hematological parameters in the differential diagnosis of idiopathic granulomatous mastitis (IGM) and breast cancer (BC) are limited. This study investigated whether preoperative fibrinogen and hematological indexes can be used in the differential diagnosis of patients with IGM and early-onset BC. Methods: Fifty patients with BC, 55 patients with IGM, and 50 healthy volunteer women were included in the study. Results: There was a statistically significant difference between the IGM and the BC with respect to fibrinogen, fibrinogen/albumin (Fib/Alb) ratio, C-reactive protein (CRP), white blood cells (WBC), neutrophils, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and monocyte values. When fibrinogen (p < 0.001), the Fib/Alb ratio (p < 0.001), CRP (p < 0.001), WBC (p < 0.001), neutrophil (p < 0.001), NLR (p < 0.001), monocyte (p = 0.008), and 2-hour sedimentation rate (p < 0.001) were compared between the groups, the highest levels were found in the IGM group. There was a negative relationship between CRP and albumin, and a positive relationship was observed between CRP and WBC, NLR, PLR, and 2-h sedimentation rate. CRP had the highest sensitivity (95%), whereas the Fib/Alb ratio (86%) had the highest specificity. Patients with recurrent IGM had increased fibrinogen, Fib/Alb, CRP, neutrophils, NLR, and 2-h erythrocyte sedimentation rate (ESR) and decreased lymphocyte levels compared to non-recurrent patients. Conclusions: Preoperative CRP, albumin, fibrinogen, Fib/Alb, WBC, neutrophil, NLR, monocyte, and 2-h ESR have considerable potential to be early and sensitive biomarkers of IGM caused by inflammation compared to BC. These parameters also have a significant effect on the recurrence of the disease, suggesting their potential as a practical guide for the differential diagnosis of BC from IGM.

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Section: Discussionsupporting

confidence: 94%

Preoperative Fibrinogen and Hematological Indexes in the Differential Diagnosis of Idiopathic Granulomatous Mastitis and Breast Cancer

et al. 2021

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“…ROC analysis results in the IGM group showed that cut-off values, the best sensitivity, and speci city for CRP were > 3.625 (94.55% and 70% respectively). This is consistent with the results of our other study [38] and Jacquin-Porretaz et al [39]. Contrary to these results, Yigitbasi et al…”

Section: Discussionsupporting

confidence: 93%

Preoperative Fibrinogen and Hematological Indexes in the Differential Diagnosis of Idiopathic Granulomatous Mastitis and Breast Cancer

Velidedeoğlu

Kundaktepe

Aksan

et al. 2021

Preprint

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Background and Aim: Studies on hematological parameters in the differential diagnosis of idiopathic granulomatous mastitis (IGM) and breast cancer (BC) are limited. This study investigated whether preoperative fibrinogen and hematological indexes can be used in the differential diagnosis of patients with IGM and early-onset BC. Methods: Fifty patients with BC, 55 patients with IGM, and 50 healthy volunteer women were included in the study. Results: There was a statistically significant difference between the IGM and the BC with respect to fibrinogen, fibrinogen/albumin (Fib/Alb) ratio, C - reactive protein (CRP), white blood cells (WBC), neutrophils, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and monocyte values. When fibrinogen (p <0.001), Fib/Alb ratio (p <0.001), CRP (p <0.001), WBC (p <0.001), neutrophil (p <0.001), NLR (p <0.001), monocyte (p = 0.008), and 2-hour sedimentation rate (p <0.001) were compared between the groups, the highest levels were found in the IGM group. There was a negative relationship between CRP and albumin, and a positive relationship was observed between CRP and WBC, NLR, PLR, and 2-h sedimentation rate. CRP had the highest sensitivity (95%), whereas the Fib/Alb ratio (86%) had the highest specificity. Patients with recurrent IGM had increased fibrinogen, FIB/ALB, CRP, neutrophils, NLR, and 2-h erythrocyte sedimentation rate (ESR) and decreased lymphocyte levels compared to non-recurrent patients. Conclusions: Preoperative CRP, albumin, fibrinogen, Fib/Alb, WBC, neutrophil, NLR, monocyte, and 2-h ESR have considerable potential to be early and sensitive biomarkers of IGM caused by inflammation compared to BC. These parameters also have a significant effect on the recurrence of the disease, suggesting a practical guide for the differential diagnosis of BC from IGM.

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“…10 Histology helps to rule out differential diagnosis and to confirm the diagnosis of IGM. 2,3 It typically demonstrates granulomas located in the center of the breast lobule with dense neutrophilic infiltration that may form micro-abscesses. It consists on non-caseating granulomas with multinucleated giant cells and epithelioid histiocytes.…”

Section: Discussionmentioning

confidence: 99%

“…Association of IGM and erythema nodosum is a rare feature, less than 30 cases have been reported in the literature. 2,3 IGM may simulate malignancy or infection such as breast tuberculosis. 4,5 Due to the fact that clinical manifestations and radiological images are similar to those of breast tuberculosis, IGM may be misdiagnosed and treated as tuberculosis especially in an endemic area.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic Granulomatous Mastitis as an Unusual Cause of Erythema Nodosum in a Malagasy Woman

Rakotoarisaona¹,

Razafimaharo²,

Razanakoto³

et al. 2023

IMCRJ

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Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease. Neoplastic and infectious etiologies must be ruled out. IGM is a diagnostic challenge for countries with high tuberculosis endemicity like Madagascar since it may clinically and radiologically mimic breast tuberculosis. We report a case of IGM associated with erythema nodosum in a Malagasy. Case Report: A 29-year-old primiparous woman came to a dermatological consultation for typical erythema nodosum lesions that appeared one month after a breast swelling. She had no particular medical history. Examination revealed typical erythema nodosum lesions on the legs, voluminous tender mass in the right breast. Bacteriological samples and tuberculosis test were negative. Imaging showed mastitis on the right breast with no evidence of malignancy. Histology revealed a non-caseating granulomas on the lobule of the right breast. As part of an etiological work-up, COVID-19 serology was performed with a positive IgG antibody. The diagnosis of IGM associated with erythema nodosum was evocated. The evolution was favorable under systemic corticosteroid therapy. Discussion: The cause of this uncommon lesion remains obscure. The extramammary localizations such as erythema nodosum and arthralgia suggest an autoimmune origin. This pathogenesis is also reinforced by a good response to systemic immunosuppression. In our patient, the etiological assessment of the mastitis revealed a chronic infection with SARS-CoV-2. Histopathology is the gold standard for the IGM diagnosis which demonstrates a lobulocentric granulomas without caseous necrosis. Oral corticosteroid therapy is the initial choice of treatment. Conclusion: Now, with several cases of concomitant IGM and EN reported, dermatologists should be aware that erythema nodosum can be one of the presenting signs of IGM, since the two conditions appear to be associated. The particularity of our case lies in the incidental discovery of SARS-CoV-2 infection. Is a chronic granulomatous disease associated with SARS-CoV-2 infection, a coincidence?

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Mastite granulomateuse idiopathique associée à un érythème noueux

Cited by 16 publications

References 35 publications

Preoperative Fibrinogen and Hematological Indexes in the Differential Diagnosis of Idiopathic Granulomatous Mastitis and Breast Cancer

Preoperative Fibrinogen and Hematological Indexes in the Differential Diagnosis of Idiopathic Granulomatous Mastitis and Breast Cancer

Preoperative Fibrinogen and Hematological Indexes in the Differential Diagnosis of Idiopathic Granulomatous Mastitis and Breast Cancer

Idiopathic Granulomatous Mastitis as an Unusual Cause of Erythema Nodosum in a Malagasy Woman

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