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- W2979234243 abstract "Introduction: Sclerosing Mesenteritis (SM) is a rare fibroinflammatory condition of the mesentery. We describe clinical features, treatment and outcomes of patients (pts) with SM seen at our center since 2005. Methods: Pts were identified by ICD-9 codes. Clinical data was analyzed using JMP version 9.0.1. Results: 145 pts had a median age 63 yrs; 69% male. Symptoms included pain (75%), weight loss (37%), distention/bloating (36%), and nausea or vomiting (34%); 24 (17%) had incidental (asymptomatic [Asx) SM. Complications at presentation: bowel obstruction (13%), ascites (12%), bowel ischemia (3%), and mesenteric vein thrombosis (2%). CT findings: mesenteric mass (69%) or inflammation without mass (31%); 38% had adenopathy, 48% had mesenteric calcification. Median follow-up: 2.1 yrs (range 8 d - 14 yrs). 18/24 Asx pts were not treated; 2 developed symptoms and 16 did not. 31 mildly symptomatic pts (21%) were not treated; 48% had symptom resolution, 19% improved, and 26% worsened. 51 (35%) were treated with steroids alone; 49% had symptom resolution and 24% improved; 33% were steroid dependent. 70 received tamoxifen (48%), 54 with prednisone (77%). Symptoms resolved in 35% and improved in 38%. 59% of pts treated with tamoxifen and prednisone remained steroid dependent. Azathioprine was used in 20 pts with symptom improvement in 25% and resolution in 25%. 10 received colchicine; 50% had no response, 30% remission and 20% intolerance. Thalidomide was used in 2 pts; 1 had symptom improvement with progression of CT findings; the other was lost to follow-up. 13 received pentoxifylline (9%); symptoms resolved in 25% and improved in 17%. During follow up, 18 (12%) developed obstruction, 19 ascites (13%), and 5 mesenteric vein thrombosis (3%); 11 were diagnosed with a mesenteric malignancy (8%). Sixteen pts died (11%), six of disease related causes. Changes in CT findings did not correlate with changes in symptoms during follow up. Conclusion: SM often presents with abdominal pain, although many are asymptomatic. Conservative monitoring is reasonable in Asx pts. Many mildly symptomatic pts improved without treatment. While tamoxifen was effective in treating symptoms, it was not often a steroid sparing agent. Further studies are needed to determine the role of colchicine, thalidomide, and pentoxifylline in SM. CT response does not correlate with symptom improvement. Complications may occur and close follow up is required." @default.
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- W2979234243 date "2015-10-01" @default.
- W2979234243 modified "2023-09-26" @default.
- W2979234243 title "Sclerosing Mesenteritis: Clinical Features, Treatment, and Outcomes Presidential Poster" @default.
- W2979234243 doi "https://doi.org/10.14309/00000434-201510001-02431" @default.
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