Sclerosing mesenteritis associated with giant-cell temporal arteritis

Area of Science:

• Gastroenterology
• Rheumatology
• Vascular Medicine

Background:

• Sclerosing mesenteritis (SM) is a rare benign chronic inflammatory disease of the mesentery.
• Giant-cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
• The co-occurrence of SM and GCA is not well-documented.

Purpose of the Study:

• To report a case of simultaneous sclerosing mesenteritis and giant-cell arteritis.
• To discuss the potential association between these two conditions.
• To suggest a diagnostic approach for patients presenting with SM.

Main Methods:

• Case report of a 72-year-old man with abdominal pain, headache, and weight loss.
• Diagnostic workup included CT scan, mesenteric tissue biopsy, and temporal artery biopsy.
• Treatment involved steroid therapy.

Main Results:

• CT scan revealed sclerosing mesenteritis.
• Mesenteric biopsy excluded malignancy.
• Temporal artery biopsy confirmed giant-cell arteritis.
• Both conditions responded to steroid treatment and relapsed simultaneously upon withdrawal.

Conclusions:

• The association between SM and GCA, while potentially coincidental, warrants further investigation.
• Screening for GCA should be considered in elderly patients diagnosed with SM, especially those exhibiting suggestive symptoms.
• A temporal artery biopsy may be a valuable diagnostic tool in such cases.