Mastitis causes: Difference between revisions
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Most clinically significant cases present as inflammation of the ductal and lobular system (galactophoritis) and possibly the immediately surrounding tissue. | Most clinically significant cases present as inflammation of the ductal and lobular system (galactophoritis) and possibly the immediately surrounding tissue. | ||
Secretory stasis is the cause of nonpuerperal mastitis in about 80% of cases (Lanyi 2003). The retained secretions can get infected or cause inflammation by causing mechanical damage or leaking the lactiferous | Secretory stasis is the cause of nonpuerperal mastitis in about 80% of cases (Lanyi 2003). The retained secretions can get infected or cause [[inflammation]] by causing mechanical damage or leaking the [[lactiferous duct]]s. | ||
Autoimmune reaction to the | [[Autoimmune]] reaction to the [[secretion]]s may be also a factor. | ||
Several mechanisms are discussed throughout literature that may cause or predispose this (Lanyi 2003, Peters & Schuth 1989, Goepel & Pahnke 1991, Krause et al 1994). | Several mechanisms are discussed throughout literature that may cause or predispose this (Lanyi 2003, Peters & Schuth 1989, Goepel & Pahnke 1991, Krause et al 1994). | ||
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* secretory disease or [[galactorrhea]] | * secretory disease or [[galactorrhea]] | ||
* changes in [[permeability]] of lactiferous ducts (retention syndrome) | * changes in [[permeability]] of lactiferous ducts (retention syndrome) | ||
* blockage of lactiferous ducts, for example duct plugging caused by squamous metaplasia of lactiferous ducts | * blockage of lactiferous ducts, for example duct plugging caused by squamous [[metaplasia]] of lactiferous ducts | ||
* trauma, injury | * trauma, injury | ||
* mechanical irritation caused by retention syndrome or | * mechanical irritation caused by [[retention syndrome]] or [[Fibrocystic]] Condition | ||
* infection | * [[infection]] | ||
* autoimmune reaction to luminal fluid | * autoimmune reaction to luminal fluid | ||
About 25% of patients may be hyperprolactinemic and significant coincidence with | About 25% of patients may be hyperprolactinemic and significant coincidence with Fibrocystic Condition and [[thyroid]] anomalies has been documented (Peters & Schuth 1989, Goepel & Pahnke 1991). Up to 50% of patients experience transient [[hyperprolactinemia]] possibly caused by the inflammation or treatment and most had abnormally high [[Prolactin]] reserve (Goepel & Pahnke 1991). | ||
Up to 50% of | |||
(Goepel & Pahnke 1991). | |||
Prolactin, IGF-1 and TSH are important sytemic factors in galactopoesis, their significance in secretory disease is not documented but it has been asserted that the mechanisms of secretory disease and galactopiesis are closely related (Lanyi 2003). | Prolactin, [[IGF-1]] and [[TSH]] are important sytemic factors in galactopoesis, their significance in secretory disease is not documented but it has been asserted that the mechanisms of secretory disease and galactopiesis are closely related (Lanyi 2003). | ||
Permeability the of the alveolar and ductal epithelia is mostly controlled by tight junction regulation and is closely linked to galactopoiesis and possibly secretory disease. The tight junctions are regulated by a multitude of systemic (prolactin, progesterone, | Permeability the of the alveolar and ductal [[epithelia]] is mostly controlled by tight junction regulation and is closely linked to galactopoiesis and possibly secretory disease. The tight junctions are regulated by a multitude of systemic (prolactin, [[progesterone]], [[glucocorticoid]]s) and local (intramammary pressure, [[TGF-beta]], [[osmotic]] balance) factors (Nguyen & Neville 1998) | ||
[[Tobacco smoking]] appears to be an important factor in the aetiology of squamous metaplasia of lactiferous ducts, around 90% of patients with this condition are smokers. Current smokers have the worst prognosis and highest rate of recurrent | [[Tobacco smoking]] appears to be an important factor in the aetiology of squamous metaplasia of lactiferous ducts, around 90% of patients with this condition are smokers. Current smokers have the worst [[prognosis]] and highest rate of recurrent [[abscess]]es. | ||
Acromegaly may present with symptoms of nonpuerperal mastitis. | [[Acromegaly]] may present with symptoms of nonpuerperal mastitis. | ||
Diabetes and many conditions with suppressed immune system can cause various infections of the breast and mastitis. Such conditions often present with inflammation of peripheral tissue and exotic infections. | [[Diabetes]] and many conditions with suppressed immune system can cause various infections of the breast and mastitis. Such conditions often present with inflammation of peripheral tissue and exotic infections. | ||
Nipple piercings pose a risk due to bacterial infection following the injury and hormonal stimulation by the piercing (Jacobs et al 2003, Modest & Fangman 2002, Demirtas et al 2003). | Nipple piercings pose a risk due to bacterial infection following the injury and hormonal stimulation by the piercing (Jacobs et al 2003, Modest & Fangman 2002, Demirtas et al 2003). | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Needs causes]] | |||
[[Category:Needs overview]] | |||
Revision as of 16:47, 21 November 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
Nonpuerperal mastitis: Aetiology and Pathogenesis
Most clinically significant cases present as inflammation of the ductal and lobular system (galactophoritis) and possibly the immediately surrounding tissue.
Secretory stasis is the cause of nonpuerperal mastitis in about 80% of cases (Lanyi 2003). The retained secretions can get infected or cause inflammation by causing mechanical damage or leaking the lactiferous ducts. Autoimmune reaction to the secretions may be also a factor.
Several mechanisms are discussed throughout literature that may cause or predispose this (Lanyi 2003, Peters & Schuth 1989, Goepel & Pahnke 1991, Krause et al 1994).
- secretory disease or galactorrhea
- changes in permeability of lactiferous ducts (retention syndrome)
- blockage of lactiferous ducts, for example duct plugging caused by squamous metaplasia of lactiferous ducts
- trauma, injury
- mechanical irritation caused by retention syndrome or Fibrocystic Condition
- infection
- autoimmune reaction to luminal fluid
About 25% of patients may be hyperprolactinemic and significant coincidence with Fibrocystic Condition and thyroid anomalies has been documented (Peters & Schuth 1989, Goepel & Pahnke 1991). Up to 50% of patients experience transient hyperprolactinemia possibly caused by the inflammation or treatment and most had abnormally high Prolactin reserve (Goepel & Pahnke 1991).
Prolactin, IGF-1 and TSH are important sytemic factors in galactopoesis, their significance in secretory disease is not documented but it has been asserted that the mechanisms of secretory disease and galactopiesis are closely related (Lanyi 2003).
Permeability the of the alveolar and ductal epithelia is mostly controlled by tight junction regulation and is closely linked to galactopoiesis and possibly secretory disease. The tight junctions are regulated by a multitude of systemic (prolactin, progesterone, glucocorticoids) and local (intramammary pressure, TGF-beta, osmotic balance) factors (Nguyen & Neville 1998)
Tobacco smoking appears to be an important factor in the aetiology of squamous metaplasia of lactiferous ducts, around 90% of patients with this condition are smokers. Current smokers have the worst prognosis and highest rate of recurrent abscesses.
Acromegaly may present with symptoms of nonpuerperal mastitis.
Diabetes and many conditions with suppressed immune system can cause various infections of the breast and mastitis. Such conditions often present with inflammation of peripheral tissue and exotic infections.
Nipple piercings pose a risk due to bacterial infection following the injury and hormonal stimulation by the piercing (Jacobs et al 2003, Modest & Fangman 2002, Demirtas et al 2003).