Post-operative Ayurvedic management of non-healing idiopathic granulomatous mastitis - A case report.
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ABSTRACT:
SUBMITTER: Balakrishnan M
PROVIDER: S-EPMC8642695 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Introduction and importanceIdiopathic granulomatous mastitis is an uncommon, long-lasting inflammatory condition of the female breast. It is characterized by the development of a painful breast mass that gradually increases in size. This condition is benign and its cause is unknown. It primarily affects women of childbearing age who have a history of pregnancy and breastfeeding. The main feature of idiopathic granulomatous mastitis is the presence of chronic inflammation in the breast.Case presentationWe report a 36-year-old woman with a history of pregnancy and breastfeeding presented with pain and swelling of the right breast. Physical examination revealed a mass with redness and retraction of the nipple. Imaging revealed localized density and hypoechoic areas with collection, suggesting granulomatous mastitis. A biopsy confirmed the diagnosis. The abscess was drained through a small incision performed under local anesthesia. Treatment with corticosteroids resulted in significant improvement, with complete resolution after one month.Clinical discussionA comprehensive evaluation of potential causes is necessary to confirm the diagnosis of idiopathic granulomatous mastitis. Histologically, it is distinguished by the predominant presence of neutrophils and the absence of caseous necrosis. Treatment remains controversial, with recent literature supporting the efficacy of conservative management with steroid and immunosuppressive therapy, leaving surgical excision for complicated and refractory cases.ConclusionsIdiopathic granulomatous mastitis is an uncommon breast condition where the exact causes and recommended treatment approaches are not well-defined. It is important to consider this condition in women who are in their reproductive years.
| S-EPMC11004635 | biostudies-literature
Project description:Idiopathic granulomatous mastitis (IGM) is a rare condition characterised by chronic inflammation and granuloma formation in the breast. The aetiology of IGM is unclear. By focusing on the protein-coding regions of the genome, where most disease-related mutations often occur, whole-exome sequencing (WES) is a powerful approach for investigating rare and complex conditions, like IGM. We report WES results on paired blood and tissue samples from eight IGM patients. Samples were processed using standard genomic protocols. Somatic variants were called with two analytical pipelines: nf-core/sarek with Strelka2 and GATK4 with Mutect2. Our WES study of eight patients did not find evidence supporting a clear genetic component. The discrepancies between variant calling algorithms, along with the considerable genetic heterogeneity observed amongst the eight IGM cases, indicate that common genetic drivers are not readily identifiable. With only three genes, CHIT1, CEP170, and CTR9, recurrently altering in multiple cases, the genetic basis of IGM remains uncertain. The absence of validation for somatic variants by Sanger sequencing raises further questions about the role of genetic mutations in the disease. Other potential contributors to the disease should be explored.
| S-EPMC11354296 | biostudies-literature
Project description:Idiopathic granulomatous mastitis (IGM) is a rare and benign inflammatory breast disease with ambiguous aetiology. Contrastingly, lactational mastitis (LM) is commonly diagnosed in breastfeeding women. To investigate IGM aetiology, we profiled the microbial flora of pus and skin in patients with IGM and LM. A total of 26 patients with IGM and 6 patients with LM were included in the study. The 16S rRNA sequencing libraries were constructed from 16S rRNA gene amplified from total DNA extracted from pus and skin swabs in patients with IGM and LM controls. Constructed libraries were multiplexed and paired-end sequenced on HiSeq4000. Metagenomic analysis was conducted using modified microbiome abundance analysis suite customised R-resource for paired pus and skin samples. Microbiome multivariable association analyses were performed using linear models. A total of 21 IGM and 3 LM paired pus and skin samples underwent metagenomic analysis. Bray-Curtis ecological dissimilarity distance showed dissimilarity across four sample types (IGM pus, IGM skin, LM pus, and LM skin; PERMANOVA, p < 0.001). No characteristic dominant genus was observed across the IGM samples. The IGM pus samples were more diverse than corresponding IGM skin samples (Shannon and Simpson index; Wilcoxon paired signed-rank tests, p = 0.022 and p = 0.07). Corynebacterium kroppenstedtii, reportedly associated with IGM in the literature, was higher in IGM pus samples than paired skin samples (Wilcoxon, p = 0.022). Three other species and nineteen genera were statistically significant in paired IGM pus-skin comparison after antibiotic treatment adjustment and multiple comparisons correction. Microbial profiles are unique between patients with IGM and LM. Inter-patient variability and polymicrobial IGM pus samples cannot implicate specific genus or species as an infectious cause for IGM.
| S-EPMC9863225 | biostudies-literature
Project description:Wilson's disease betides due to mutation in ATP-7B that leads to snagging in copper transport by the hepatic lysosomes resulted in the deposition of copper in the brain, liver, kidney or skeletal system. The symptoms are jaundice, edema in legs, ascites, Kayser-Fleischer rings, dysarthria, dysphagia, ataxia, dyskinesia, and muscle spasticity. Current therapeutic modalities for the management of Wilson's disease include zinc, trientine, penicillamine and ammonium tetrathiomolybdate. A 12 year old child diagnosed with Wilson's disease came with complaints of inability to speak, difficulty in swallowing and generalized stiffness for 6 months. His investigations showed SGPT 43 U/L, Ceruloplasmin 0.03 g/L, urine copper level 225.03 μg per 24 h, a chronic parenchymal disease in the liver and splenomegaly. According to Ayurveda, this case of generalized stiffness with hepatomegaly and splenomegaly was correlated with Agnimandya at the Dhatu level that led to Vatavyadhi, Yakrutodara, and Plihodara. The treatment mentioned for Vatavyadhi is Snehana (oleation), MruduSwedana (mild sudation), Anuvasana Basti (oil enema) and for Yakrutodara and Plihodara is Niruha Basti (Decoction Enema) and Anuvasana Basti (oil enema). The case was treated with Abhyanga, Swedana, Basti and oral medication. After treatment, the symptoms were reduced and he was able to extend both lower limbs completely. His urinary copper level came to normal (47.01 μg per 24 h), so, it can be concluded that the Ayurvedic approach and diet modifications in such patients may help in providing supportive care and improving the quality of life.
| S-EPMC7329710 | biostudies-literature
Project description:Limb girdle muscular dystrophy (LGMD) is a type of Muscular dystrophy (MD), heterogeneous devastating complex genetic disorders causing progressive weakness and degeneration of muscles. LGMD is hereditary autosomal diseases characterized by weak and wasteful limb girdle muscles. The available management of LGMD in biomedicine is unsatisfactory. Here we present a case of LGMD managed with combinations of Ayurvedic oral medicines and Panchakarma procedures. The Ayurvedic diagnosis of the condition was considered as Mansagata Vata (∼neuromuscular diseases), a type of Vatavyadhi (∼neuromusculo skeleton disorders). The patient was treated with Shalishashtika Pinda Swedana and Mustadi Yapana Basti for the duration of 16 days along with following Ayurvedic oral medicines: Yograj Guggulu 500 mg with 40 ml Dashamoola Kwatha, Ekangaveera Rasa 125 mg with honey, a combination of Ashwagandha Churna -2g, Satavari Churna - 2g, and Sankha Bhasma 500 mg with milk, Narsinha Churna- 3g and Ashwagandhavleha- 5g with milk. All medicines were given twice a day. Patient's condition was assessed for symptoms of pain, walking distance, power and reflexes of both upper and lower limb and psedohypertrophy of both calf muscles. Serum Creatine Phoshphokinase (S.CPK) level and electromyography (EMG) were also measured. There was symptomatic improvement in the patient's condition and reduction in S.CPK level. The study suggests that LGMD can be satisfactorily managed with Ayurvedic oral medicines and Panchakarma therapy.
| S-EPMC8728082 | biostudies-literature
Project description:BackgroundIdiopathic granulomatous mastitis (IGM) is a rare, benign, but locally aggressive breast disease. Steroids are widely used as a breast-conserving option, however, the response rate of steroids varies in reported studies, as well as its different reported usage. This prospective observational cohort study aimed to report the outcomes of methylprednisolone for IGM treatment.MethodsFrom Aug 2019 to Dec 2021, the clinicopathological information of 156 IGM patients who sought treatment at West China Hospital was prospectively collected. A total of 88 patients treated with methylprednisolone were included in the study. The clinical features, treatment response, and follow-up data were analyzed.ResultsThe median age at diagnosis was 32 years, and 90.9% of patients were multipara. The predominant symptom at presentation was painful breast mass, with a median size of 4.7 cm. For steroid usage, an initial 20 mg methylprednisolone daily was given until disease stable. The median duration of 20 mg methylprednisolone treatment was 45 (range, 14-376) days. The median duration of whole steroid therapy was 105 (range, 28-381) days. A total of 80.7% of patients (71/88) responded well to steroid treatment. In 63 patients, steroid treatment was successfully withdrawn, and treatment was completed. With an average of 283 days follow-up (range, 0-770 days), relapse was observed in 21 (33.33%) patients. Compared with patients with residual disease as shown by physical examination (PE), those with complete clinical remission (CCR) at the end of treatment had longer relapse-free intervals.ConclusionsSteroids are the preferable breast-conserving option for IGM. Treatment with 20 mg methylprednisolone for an average of 1.5 months is usually required, and full steroid treatment might last for 3 months.
| S-EPMC9547707 | biostudies-literature
Project description:Takayasu arteritis (TA) is a rare disorder and it is a devastating condition of aorta. The presently available treatments for the condition in the modern medicine have limited benefits. This is case of TA which was better managed with Ayurvedic intervention. An Ayurvedic diagnosis for this case was Siragata Vata (vitiated Vata Dosha affecting the blood vessels). A 42-year-old woman was diagnosed with TA and treated on the line of management of Siragata Vata with Shastikashali Pinda Swedana (sudation with bolus of medicated cooked rice) for 16 days, Erandamuladi Niruha Basti (enema mainly with decoction) along with Ashwagandha Taila Anuvasana (enema with medicated oil) for 16 days in Kala Basti Krama (16 days in alternate order of decoction and oleation enema) followed by one day gap and then 7 days of Nasya Karma (nasal therapy) with Triphaladi Taila (oil) on alternate days along with a combination of Ayurvedic oral drugs [Brihadvatachintamani Rasa-125 mg, Dashamula Kwatha-40 ml, Narsinha Churna (powder)-3 g, Yogaraja Guggulu-1g (500mgx2tab) and Shiva Gutika-500 mg, twice a day for 1 month. Same Panchakarma procedures were repeated after 6 months. A similar combination of oral medications were continued in between and during this period. Chyavanaprasha Aveleha in the dose of 10g twice a day with milk were also added after completion of this treatment regime. Patient condition was assessed on Indian Takayasu Clinical Activity Score (ITAS-2010) for disease activity of TA. Satisfactory results were observed in the patient with improvement in ITAS-2010 scoring. TA may be managed with Ayurvedic drugs and Panchakarma procedures.
| S-EPMC8614210 | biostudies-literature
Project description:IntroductionIdiopathic granulomatous orbital inflammation is a rare subtype of orbital inflammatory disease, and frontal nerve involvement has not been previously described.Case presentationThis is a case of a 75-year-old female who presented with a 4-week history of a right orbital mass, scalp dysaesthesia, and ptosis. Magnetic resonance imaging of the orbits confirmed a right supraorbital mass originating from the lacrimal gland with frontal nerve enlargement. Biopsy showed non-caseating granulomatous inflammation.ConclusionThe patient was treated with an intralesional triamcinolone injection and oral prednisolone and will continue to be monitored for development of systemic sarcoidosis.
| S-EPMC10691829 | biostudies-literature
Project description:Objective:Granulomatous mastitis is a rare, benign, chronic inflammatory disease of the breast of unknown etiology. This study evaluated bacteriologic agents that might play a role in the etiology of granulomatous mastitis using a molecular method with a universal primer after isolating deoxyribonucleic acid (DNA) from pathology specimens from patients diagnosed with granulomatous mastitis. Materials and Methods:Breast biopsy material in the pathology department obtained between July 2008 and June 2013 was analyzed. The history of the granulomatous mastitis patients was examined in detail and paraffin block sections of the biopsy material were used to determine the presence of bacteria with a universal DNA primer. Results:This study examined 45 granulomatous mastitis patients who had been diagnosed using excisional, incisional, or core biopsies. We evaluated multiple bacterial taxa, but obtained no positive result using a nucleic-acid-based assay with a universal primer. Conclusion:The etiology of idiopathic granulomatous mastitis remains unclear. Further studies with a large number of patients should aim to identify the causative agent.
| S-EPMC6385714 | biostudies-literature
Project description:A focus has been placed particularly on the description of breast abscesses (sthana vidradhi in Ayurveda terms). Breast inflammation known as mastitis has the potential to develop into a breastabscess in the future. The term "stana roga," refers to breast disorders and describes breast abscesses, is mentioned in the ancient works Sushruta Samhita, Madhava Nidana, and Bhavaprakasha. Breast abscesses are typically treated surgically by making an incision over the area of greatest fluctuation (or pain) and breaking the abscess septa with digits. For a few days, the abscess chamber is left untreated or gauze-packed, with dressing changes made as needed to facilitate wound granulation. The current report was aimed at management of the breast abscess through an integrated approach comprising surgical and medicinal intervetions as mentioned in Ayurveda classics. A 32-year-old female patient with pain and swelling in right breast was diagnosed with breast abscess in Shalya (Surgery) OPD and managed primarily by incision and drainage which was followed by regular dressing and ayurvedic medications which encouraged appreciable granulation in a short period of time with complete healing of the abscess. This case study presents the successful management of breast abscesses with both surgical & Ayurvedic management.
| S-EPMC10897883 | biostudies-literature