Granulomatous mastitis, erythema nodosum, and arthritis syndrome: a narrative review

作者：Shengguang Li, Jing Zhang, Ji Li, Lina Zhang, Yadan Zou, Ting Long, Ruohan Yu, Yanfeng Zhang · 发表于：Frontiers in Immunology · 年份：2025 · DOI：10.3389/fimmu.2025.1689710 · 被引用次数：7 · 研究领域：Breast Lesions and Carcinomas、Cancer Risks and Factors、Pregnancy and Medication Impact

Introduction: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory breast disease of unknown etiology, typically presenting with breast pain, swelling, and mass formation. Erythema nodosum (EN) is an inflammatory panniculitis that can occur as a systemic manifestation of various conditions, and arthritis has occasionally been observed alongside granulomatous mastitis (GM), suggesting an underlying autoimmune component. This narrative review synthesizes reported cases of GM with EN, with or without arthritis-termed "GMENA" syndrome-to characterize its clinical features and management. Methods: We searched PubMed and EMBASE for case reports and case series describing GM with co-occurring EN, with or without arthritis. Reports fulfilling these criteria were reviewed, and data on demographics, clinical presentation, laboratory and histological findings, treatment strategies, and outcomes were extracted and summarized descriptively. Results: We identified 45 reported patients with GMENA in the literature. All patients were women of reproductive age (median age approximately 32 years), and about one-third presented during pregnancy or in the postpartum period. Breast involvement was exclusively unilateral, manifesting as painful inflammatory masses often mimicking carcinoma. EN was universal (100%), usually affecting both shins and ankles, and approximately two-thirds of patients developed acute, non-erosive oligoarthritis, most commonly involving the ankles. Labo...