Rheumatologic manifestations of female patients with idiopathic granulomatous mastitis

Background: Idiopathic granulomatous mastitis (IGM) is an infrequent inflammatory breast disease that typically presents with unilateral and sometimes bilateral breast masses, leading to pain, erythema, and nipple discharge. IGM may be accompanied by extramammary symptoms, including episcleritis and arthralgia suggesting and underlying autoimmune process. Aim of the work: To evaluate the frequency of characteristics manifestations including rheumatologic in females with IGM referred to Imam Ali Hospital (Karaj, Iran). Patients and methods: This study was performed on 178 females referred to the breast surgery department of Imam Ali Hospital and diagnosed with IGM based on core needle biopsy and histopathological examination. The various manifestations including rheumatic presented for those patients were recorded. Results: The mean age of the patients was 35.17 +/- 5.88 years and body mass index was 26.38 +/- 2.45. 91 % of the patients were nulliparous and only 3 used oral contraceptive pills. The breast-feeding duration of parous patients was 28.91 +/- 14.97 months. Associated minor thalassemia was present in 2.25 %, bronchial asthma, diabetes, psoriasis and hypothyroidism were present in 2 patients each. 7 (3.92 %) of cases had history of previous breast surgery. Twenty-five (14 %) patients with IGM had associated manifestations including arthralgia (10.11 %), arthritis (2.25 %) and erythema nodosum (2.81 %). Only one patient had peripheral and another optic neuritis. 158 (88.76 %) patients had no notable past medical history. IGM was bilateral in 21 (11.8 %) patients. Conclusions: The coexistence of erythema nodosum and arthritis with IGM is not uncommon. They are mostly unilaterally present in nulliparous Iranian females. Optic and peripheral neuropathies are rarely associated.