Bothara Rishi, Umer Imran, Bhalodia Alisha, Rehman Muneeb, Amar Zain
Internal Medicine, University of Illinois, Peoria, USA.
Rheumatology, University of Illinois, Peoria, USA.
Cureus. 2024 Jul 20;16(7):e64993. doi: 10.7759/cureus.64993. eCollection 2024 Jul.
This case report highlights the importance of recognizing granulomatosis with polyangiitis (GPA) as a rare but potential cause of recurrent granulomatous mastitis and breast abscesses. The case report describes a patient who presented with recurrent breast abscesses over many years, initially misdiagnosed as infectious mastitis, until a breast tissue biopsy revealed granulomatous inflammation. Further evaluation confirmed the diagnosis of GPA based on elevated anti-neutrophil cytoplasmic antibodies (ANCA). The authors emphasize that, while breast involvement is exceedingly rare in GPA, it should be considered in cases of refractory granulomatous mastitis, even in the absence of typical systemic GPA manifestations. Early recognition can prevent misdiagnosis, allow timely initiation of immunosuppressive treatment, and avoid unnecessary procedures. The report calls for improved awareness and further research into the clinical characteristics and optimal management strategies for GPA presenting with breast lesions.
本病例报告强调了认识肉芽肿性多血管炎(GPA)作为复发性肉芽肿性乳腺炎和乳腺脓肿的一种罕见但潜在病因的重要性。该病例报告描述了一名多年来反复出现乳腺脓肿的患者,最初被误诊为感染性乳腺炎,直到乳腺组织活检显示肉芽肿性炎症。进一步评估基于抗中性粒细胞胞浆抗体(ANCA)升高确诊为GPA。作者强调,虽然GPA累及乳腺极为罕见,但在难治性肉芽肿性乳腺炎病例中应予以考虑,即使没有典型的全身性GPA表现。早期识别可防止误诊,允许及时开始免疫抑制治疗,并避免不必要的手术。该报告呼吁提高对伴有乳腺病变的GPA的认识,并进一步研究其临床特征和最佳管理策略。