Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players
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 dise...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-03-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/9/4/958 |
| _version_ | 1797417387435229184 |
|---|---|
| author | Radjiv Goulabchand Assia Hafidi Philippe Van de Perre Ingrid Millet Alexandre Thibault Jacques Maria Jacques Morel Alain Le Quellec Hélène Perrochia Philippe Guilpain |
| author_facet | Radjiv Goulabchand Assia Hafidi Philippe Van de Perre Ingrid Millet Alexandre Thibault Jacques Maria Jacques Morel Alain Le Quellec Hélène Perrochia Philippe Guilpain |
| author_sort | Radjiv Goulabchand |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T06:18:03Z |
| format | Article |
| id | doaj.art-b12e84dd099e4a50a22c31c7ca01b1ef |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T06:18:03Z |
| publishDate | 2020-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b12e84dd099e4a50a22c31c7ca01b1ef2023-12-03T11:50:54ZengMDPI AGJournal of Clinical Medicine2077-03832020-03-019495810.3390/jcm9040958Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key PlayersRadjiv Goulabchand0Assia Hafidi1Philippe Van de Perre2Ingrid Millet3Alexandre Thibault Jacques Maria4Jacques Morel5Alain Le Quellec6Hélène Perrochia7Philippe Guilpain8St 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, FranceMontpellier School of Medicine, University of Montpellier, 34967 Montpellier, FrancePathogenesis and Control of Chronic Infections, Univ Montpellier, INSERM, EFS, Montpellier University Hospital, 34394 Montpellier, FranceMontpellier School of Medicine, University of Montpellier, 34967 Montpellier, FranceSt 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, FranceMontpellier School of Medicine, University of Montpellier, 34967 Montpellier, FranceSt 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, FranceMontpellier School of Medicine, University of Montpellier, 34967 Montpellier, FranceSt 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, FranceMastitis 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.https://www.mdpi.com/2077-0383/9/4/958mastitisbreast lymphocytic infiltratesmammary duct ectasiagranulomatous mastitisvasculitisIgG4-related disease |
| spellingShingle | Radjiv Goulabchand Assia Hafidi Philippe Van de Perre Ingrid Millet Alexandre Thibault Jacques Maria Jacques Morel Alain Le Quellec Hélène Perrochia Philippe Guilpain Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players Journal of Clinical Medicine mastitis breast lymphocytic infiltrates mammary duct ectasia granulomatous mastitis vasculitis IgG4-related disease |
| title | Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players |
| title_full | Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players |
| title_fullStr | Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players |
| title_full_unstemmed | Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players |
| title_short | Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players |
| title_sort | mastitis in autoimmune diseases review of the literature diagnostic pathway and pathophysiological key players |
| topic | mastitis breast lymphocytic infiltrates mammary duct ectasia granulomatous mastitis vasculitis IgG4-related disease |
| url | https://www.mdpi.com/2077-0383/9/4/958 |
| work_keys_str_mv | AT radjivgoulabchand mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT assiahafidi mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT philippevandeperre mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT ingridmillet mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT alexandrethibaultjacquesmaria mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT jacquesmorel mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT alainlequellec mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT heleneperrochia mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers AT philippeguilpain mastitisinautoimmunediseasesreviewoftheliteraturediagnosticpathwayandpathophysiologicalkeyplayers |