Sclerosing mesenteritis: clinical features, treatment, and outcome in ninety-two patients
| Autor: | Thomas C. Smyrk, Salma Akram, John A. Schaffner, Darrell S. Pardi |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Abdominal pain Retractile Mesenteritis Anti-Inflammatory Agents Sclerosing mesenteritis Retroperitoneal fibrosis Panniculitis Peritoneal Cohort Studies Estrogen Receptor Modulators Interquartile range Prednisone medicine Humans Prospective cohort study Digestive System Surgical Procedures Aged Retrospective Studies Hepatology business.industry Gastroenterology Retrospective cohort study Middle Aged medicine.disease Surgery Treatment Outcome Female medicine.symptom business Immunosuppressive Agents medicine.drug |
| Zdroj: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 5(5) |
| ISSN: | 1542-7714 |
| Popis: | Background & Aims: Sclerosing mesenteritis is a rare non-neoplastic disease that affects the small bowel mesentery with chronic fibrosing inflammation. There are few data on the natural history and therapeutic options for this condition. Methods: We performed a retrospective and prospective study to describe the clinical characteristics, therapy, and outcome of all cases of sclerosing mesenteritis diagnosed at the Mayo Clinic, Rochester, from 1982–2005. Results: Ninety-two cases were identified; 70% were male, with a median age of 65 years (interquartile range, 55–72). Common presenting symptoms included abdominal pain in 70%, diarrhea in 25%, and weight loss in 23%. Treatment included medical therapy alone in 26%, surgery alone in 13%, surgery followed by medical therapy in 9%, and 52% received no treatment. Ten percent responded to surgery alone, 20% responded to additional medical treatment after surgery, and 38% responded to medical therapy alone. Tamoxifen in combination with prednisone was used in 20 patients, and 60% improved. Non-tamoxifen–based regimens were used in 12 patients, and 8% improved. Eighteen deaths were noted during the study period, and 17% were attributed to complications of sclerosing mesenteritis or its treatment. Conclusions: Although a relatively benign condition, sclerosing mesenteritis can have a prolonged debilitating course with a fatal outcome. Our results suggest that symptomatic patients might benefit from medical therapy, particularly tamoxifen and prednisone combination treatment. Long-term follow-up is needed to substantiate these results. |
| Databáze: | OpenAIRE |
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