Altıntaş Tansu
Clinic of General Surgery, İstanbul Health Science University Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye.
Turk J Surg. 2022 Sep 19;38(3):250-254. doi: 10.47717/turkjsurg.2022.5576. eCollection 2022 Sep.
Low-dose steroid therapy has been recommended in idiopathic granulomatous mastitis (IGM) in various studies in the literature, but the therapeutic minimum dose has not been determined yet. Furthermore, vitamin D deficiency, the effect of which is accepted in autoimmune diseases, has not been previously examined in IGM. The aim of our study was to evaluate the efficacy of lower dose steroid theraphy with adjustment of vitamin D replacement doses with measuring serum 25-hydroxyvitamin D levels in patients with idiopathic granulomatous mastitis (IGM).
Vitamin D levels were evaluated in 30 IGM patients who applied to our clinic between 2017-2019. Vitamin D replacement was performed in patients with serum 25-hydroxyvitamin D level below 30 ng/mL and prednisolone was given to all patients at a dose of 0.05-0.1 mg/kg/ day. Clinical recovery times of the patients were compared with the literature.
Vitamin D replacement was given to 22 (73.33%) patients. Recovery time was shorter in patients receiving vitamin D replacement (7.62 ± 2.38; 9.00 ± 3.38; p= 0.680). Average recovery time was 8.00 ± 2.68 weeks.
Treatment of IGM can be carried out with lower dose steroid therapy, leading to less complications and lower costs. Measuring serum 25-hydroxyvitamin D level and treating it with the appropriate dose may contribute to the healing process.
在各类文献研究中,均推荐对特发性肉芽肿性乳腺炎(IGM)采用低剂量类固醇疗法,但尚未确定治疗的最小剂量。此外,维生素D缺乏在自身免疫性疾病中的作用已得到认可,然而此前尚未在IGM中进行过研究。我们研究的目的是通过测量特发性肉芽肿性乳腺炎(IGM)患者血清25-羟维生素D水平,调整维生素D替代剂量,评估低剂量类固醇疗法的疗效。
对2017年至2019年间到我们诊所就诊的30例IGM患者的维生素D水平进行评估。血清25-羟维生素D水平低于30 ng/mL的患者进行维生素D替代治疗,所有患者均给予泼尼松龙,剂量为0.05 - 0.1 mg/kg/天。将患者的临床恢复时间与文献进行比较。
22例(73.33%)患者接受了维生素D替代治疗。接受维生素D替代治疗的患者恢复时间更短(7.62 ± 2.38;9.00 ± 3.38;p = 0.680)。平均恢复时间为8.00 ± 2.68周。
IGM的治疗可采用低剂量类固醇疗法,并发症更少且成本更低。测量血清25-羟维生素D水平并用适当剂量进行治疗可能有助于愈合过程。