Clinical associations, outcomes, and therapeutic management of patients with symptomatic sclerosing mesenteritis
Related Experiment Video
Updated: Aug 7, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Christina Liava1, Danai Chourmouzi2, Georgia Gioula3
1Fourth Department of Internal Medicine, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Background:
Sclerosing mesenteritis (SM) is a rare fibroinflammatory disease of unknown etiology that primarily affects the root of the small bowel mesentery. Associated diseases that contribute to or predispose to the development of SM have not been well-documented.
Objectives:
We aimed to describe the clinical associations of patients diagnosed with symptomatic SM, their clinical features, outcomes, and therapeutic management.
Design:
We performed a prospective cohort study from 2014 to 2025.
Methods:
Eligible patients were those aged ≥ 18 years who presented at two tertiary Medical Centers in Greece with SM-specific symptoms after ruling out other causes of abdominal pain and radiographic signs indicative of the Coulier criteria on computed tomography scans (N=58). SM cases lost to follow-up were excluded (n=3). Descriptive statistics and comparative statistical analysis were used.
Results:
In total, 55 patients with symptomatic SM were included, of whom 25.5% developed severe intra-abdominal complications, with even fatal outcomes. Colchicine in combination with corticosteroid tapering was the most frequently administered therapy (47.3%). SM improved in most patients after treatment (72.9%). During the disease course, 23.6% of patients were diagnosed with immunoglobulin G4-related disease (IgG4-RD), 9.1% had co-existing systemic autoimmune rheumatic diseases, and 9.1% were diagnosed with an abdominal/pelvic malignancy within 6 months of initial SM presentation. In the remaining cases (58.2%), an association with metabolic syndrome conditions and excessive accumulation of visceral adipose tissue was observed.
Conclusion:
In this prospective cohort study, we identified a correlation of symptomatic SM with chronic inflammatory diseases. Certain SM cases are probably part of the IgG4 disease spectrum or systemic autoimmune rheumatic diseases. These results should be taken into account when consulting patients with symptomatic SM, as the clinical management, prognosis, and therapeutic approach may differ according to the underlying systemic disorder.
Insights
Sclerosing mesenteritis (SM) is linked to chronic inflammatory diseases, including IgG4-related disease and autoimmune conditions. Recognizing these associations is crucial for effective patient management and prognosis.
Area of Science:
- Gastroenterology
- Immunology
- Rheumatology
Background:
- Sclerosing mesenteritis (SM) is a rare fibroinflammatory condition affecting the small bowel mesentery.
- The etiology of SM is unknown, and its associated conditions are poorly documented.
Purpose of the Study:
- To describe clinical associations, features, outcomes, and management of symptomatic SM.
- To investigate potential links between SM and other systemic diseases.
Main Methods:
- Prospective cohort study of 55 adult patients with symptomatic SM.
- Diagnosis confirmed via computed tomography (CT) scans meeting Coulier criteria.
- Descriptive and comparative statistical analyses were employed.
Main Results:
- 25.5% of patients experienced severe complications or fatal outcomes.
- Common comorbidities included IgG4-related disease (23.6%), autoimmune rheumatic diseases (9.1%), and malignancy (9.1%).
- Metabolic syndrome and visceral adiposity were noted in 58.2% of cases.
Conclusions:
- Symptomatic SM is correlated with chronic inflammatory and autoimmune diseases.
- SM may be part of the IgG4-related disease spectrum or overlap with systemic autoimmune rheumatic diseases.
- Clinical management and prognosis depend on underlying systemic disorders.
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