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Toba T, Ikegami R, Nogami A, Watanabe N, Fujii K, Ogawa Y, Hojo A, Fujimoto A, Matsuda T. Multiple ulcerative colitis-associated aseptic abscesses successfully treated with infliximab: a case report. Clin J Gastroenterol 2023:10.1007/s12328-023-01807-9. [PMID: 37097421 DOI: 10.1007/s12328-023-01807-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023]
Abstract
Aseptic abscesses are rare extraintestinal manifestations of inflammatory bowel disease. Herein, we present the case of a 69-year-old female patient with ulcerative colitis in whom multiple aseptic abscesses were successfully treated with infliximab. Aseptic abscesses associated with ulcerative colitis are difficult to differentiate from infectious abscesses. In the present case, we reached a diagnosis of aseptic abscesses associated with ulcerative colitis as antibiotics were ineffective and repeated Gram stains and cultures of blood and abscess were negative. Aseptic abscesses are commonly found in the spleen, lymph nodes, liver, and skin; however, in the present case, the periosteum was the major site. Prednisolone is often effective for aseptic abscesses; however, the present patient was initially treated with a combination of 40 mg/day of prednisolone and granulocyte and monocyte adsorption apheresis, with inadequate effect. Infliximab was administered as the patient was steroid-resistant, with strong effect. Subsequently, infliximab treatment has been continued, with no recurrence after 2 years. However, as there have been reports of cases of recurrence even after remission with treatment, careful follow-up in the future is therefore necessary.
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Affiliation(s)
- Takahito Toba
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan.
| | - Ryo Ikegami
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Akira Nogami
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Naoko Watanabe
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Kodai Fujii
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Yurie Ogawa
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Aya Hojo
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Ai Fujimoto
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
| | - Takahisa Matsuda
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, 6-11-1, Omorinisi, Ota-Ku, Tokyo, 143-8541, Japan
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Goulabchand R, Hafidi A, Van de Perre P, Millet I, Maria ATJ, Morel J, Le Quellec A, Perrochia H, Guilpain P. Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players. J Clin Med 2020; 9:jcm9040958. [PMID: 32235676 PMCID: PMC7231219 DOI: 10.3390/jcm9040958] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/13/2022] Open
Abstract
Mastitis frequently affects women of childbearing age. Of all the pathological breast conditions requiring specific management, autoimmune mastitis is in the third position after infection and breast cancer. The aim of this literature review was to make a comprehensive description of autoimmune diseases targeting the mammary gland. Four main histological patterns of autoimmune mastitis are described: (i) lymphocytic infiltrates; (ii) ductal ectasia; (iii) granulomatous mastitis; and (iv) vasculitis. Our literature search found that all types of autoimmune disease may target the mammary gland: organ-specific diseases (diabetes, thyroiditis); connective tissue diseases (such as systemic erythematosus lupus or Sjögren’s syndrome); vasculitides (granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis, giant cell arteritis, polyarteritis nodosa, Behçet’s disease); granulomatous diseases (sarcoidosis, Crohn’s disease); and IgG4-related disease. Cases of breast-specific autoimmune diseases have also been reported, including idiopathic granulomatous mastitis. These breast-limited inflammatory diseases are sometimes the first symptom of a systemic autoimmune disease. Although autoimmune mastitis is rare, it is probably underdiagnosed or misdiagnosed. Early diagnosis may allow us to detect systemic diseases at an earlier stage, which could help to initiate a prompt, appropriate therapeutic strategy. In case of suspected autoimmune mastitis, we hereby propose a diagnostic pathway and discuss the potential pathophysiological pathways leading to autoimmune breast damage.
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Affiliation(s)
- Radjiv Goulabchand
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Internal Medicine Department, Caremeau University Hospital, 30029 Nimes, France
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Inserm U1183, Institute for Regenerative Medicine and Biotherapy, St Eloi Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Assia Hafidi
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Gui de Chauliac Hospital, Pathology Department, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, Univ Montpellier, INSERM, EFS, Montpellier University Hospital, 34394 Montpellier, France;
| | - Ingrid Millet
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Lapeyronie Hospital, Montpellier University, Medical Imaging Department, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Alexandre Thibault Jacques Maria
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Inserm U1183, Institute for Regenerative Medicine and Biotherapy, St Eloi Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Jacques Morel
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Department of Rheumatology, CHU and University of Montpellier, 34295 Montpellier, France
| | - Alain Le Quellec
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
| | - Hélène Perrochia
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Gui de Chauliac Hospital, Pathology Department, 80 Avenue Augustin Fliche, 34295 Montpellier, France
| | - Philippe Guilpain
- St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; (R.G.); (A.T.J.M.); (A.L.Q.)
- Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France (I.M.); (J.M.); (H.P.)
- Inserm U1183, Institute for Regenerative Medicine and Biotherapy, St Eloi Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier, France
- Correspondence: ; Tel.: +33-467-337332
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Panos Z, Giannopoulos G, Papangeli E, Antalis E, Pavli A, Spathis A, Poulakou G, Dimitriadis G, Panayiotides I, Boumpas D, Tsiodras S. Aseptic abscess syndrome associated with traveler's diarrhea after a trip to Malaysia. IDCases 2016; 6:23-5. [PMID: 27672562 PMCID: PMC5035335 DOI: 10.1016/j.idcr.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/11/2016] [Indexed: 11/20/2022] Open
Abstract
The first, to our knowledge, case of the aseptic abscesses syndrome as a complication of traveler’s diarrhea after a trip to Malaysia is presented. The patient failed to respond to several antimicrobials. The diagnosis was histologically confirmed and the patient only responded to immunomodulatory therapy with corticosteroids and methotrexate. Travel physicians should be aware of this entity reviewed herein in the context of traveler’s diarrhea.
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Affiliation(s)
- Zois Panos
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - George Giannopoulos
- 2nd Propaideutic Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Eymorfia Papangeli
- 2nd Propaideutic Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Emmanouil Antalis
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Androula Pavli
- Travel Medicine Office, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Aris Spathis
- Department of Cytopathology, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Garyfalia Poulakou
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - George Dimitriadis
- 2nd Propaideutic Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Ioannis Panayiotides
- 2nd Department of Pathology, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Dimitrios Boumpas
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
| | - Sotirios Tsiodras
- 4th Department of Internal Medicine, National and Kapodistrian University of Athens School of Medicine, University General Hospital “Attikon”, Athens, Greece
- Corresponding author at: 4th Department of Internal Medicine University General Hospital “Attikon”, 1 Rimini street, Chaidari, Athens 12462, Greece.4th Department of Internal MedicineNational and Kapodistrian University of Athens School of MedicineUniversity General Hospital “Attikon”AthensGreece
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