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J Rheumatol. 2019 Jun 15. pii: jrheum.181205. doi: 10.3899/jrheum.181205. [Epub ahead of print]

Methotrexate in the Treatment of Idiopathic Granulomatous Mastitis.

Author information

1
From the Division of Immunology and Rheumatology, Department of Pathology, Department of Surgery, Stanford University School of Medicine, Palo Alto, California, USA. A. Postolova, MD, MPH, Fellow in Allergy/Immunology/Rheumatology, Division of Immunology and Rheumatology, Stanford University School of Medicine; M.L. Troxell, MD, PhD, Professor of Pathology, Stanford University Medical Center; I.L. Wapnir, MD, Professor of Surgery, Department of Surgery, Stanford University School of Medicine; M.C. Genovese, MD, James W. Raitt Endowed Professor of Medicine, Co-Chief, Division of Immunology and Rheumatology, Stanford University School of Medicine. Address correspondence to Dr. A. Postolova, Division of Immunology and Rheumatology, Stanford University School of Medicine, 1000 Welch Road, Suite 203, Palo Alto, California 94305, USA. E-mail: postolov@stanford.edu. Accepted for publication June 4, 2019.

Abstract

OBJECTIVE:

Idiopathic granulomatous mastitis (IGM) is a disfiguring inflammatory breast disease without effective treatment. We report the largest IGM cohort treated with methotrexate (MTX) monotherapy.

METHODS:

Chart review was performed on patients evaluated by the Stanford Immunology and Rheumatology Clinic, with histopathologically established IGM treated with MTX, and at least 1 followup appointment.

RESULTS:

Nineteen female patients with a mean age of 33.5 years were identified. Most failed treatment with antibiotics, prednisone, and surgical intervention. By 15 months of treatment with MTX, 94% had disease improvement and 75% achieved disease remission.

CONCLUSION:

MTX monotherapy is an effective treatment for IGM.

PMID:
31203215
DOI:
10.3899/jrheum.181205

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