What is the definition of Sclerosing Mesenteritis?
Sclerosing mesenteritis is one of many terms that describes a spectrum of inflammatory disorders that affect the mesentery. The mesentery is the membrane that anchors the small intestine to the back of the abdominal wall. The condition mostly affects men between their 40s and 60s, but women and children can also be affected. It may result in a variety of symptoms including abdominal pain, nausea and vomiting, constipation or diarrhea, weight loss, and fever. Some people have an abdominal mass. The cause of the condition is poorly understood. Suggested possible causes have included previous abdominal surgery or trauma, autoimmunity, paraneoplastic syndromes, ischemic injury, and infection.
Treatment depends on the symptoms in each person and may include the use of glucocorticoids, hormonal therapy (tamoxifen or progesterone), or other medications, either alone or in combination (i.e. glucocorticoids in combination with tamoxifen). Surgery may be needed for an obstruction, if present. Although there are case reports of patients with aggressive disease and fatalities, it appears that the condition usually remains stable or is slowly progessive. In some cases, the condition goes away on its own.
What are the alternative names for Sclerosing Mesenteritis?
- Retractile mesenteritis
- Liposclerotic mesenteritis
- Mesenteric lipogranuloma
- Mesenteric fibromatosis
- Mesenteric panniculitis
- Mesenteric lipodystrophy
- Peritoneal retractile mesenteritis
- Idiopathic sclerosing mesenteritis
What are the symptoms for Sclerosing Mesenteritis?
Sclerosing mesenteritis may cause a variety of gastrointestinal and systemic symptoms, such as:
- Abdominal pain
- Nausea and vomiting
- Diarrhea or constipation
- Rectal bleeding
- Weight loss
- Abdominal distention (bloating)
- A palpable abdominal mass
Reports in the literature have indicated that symptoms can last anywhere from days to years. In severe cases, the symptoms can have a significant effect on quality of life. Some individuals develop complications such as a bowel blockage.
What are the current treatments for Sclerosing Mesenteritis?
There is no standard therapy for sclerosing mesenteritis, and treatment is based on the severity and specific symptoms in each person. Several medications have been used to try to stabilize the condition either alone or in combination. However, use of most of these medications are based on case reports or small case series. These have included:
- Glucocorticoids (prednisone)
- Hormonal therapy (tamoxifen and progesterone)
- Low dose naltrexone
Surgery is typically reserved for obstructive complications (bowel obstruction). In some cases, the condition goes away on its own.
Is Sclerosing Mesenteritis an inherited disorder?
To our knowledge, sclerosing mesenteritis is not a hereditary condition. Studies suggest
that up to 1 in 100 people may have sclerosing mesenteritis, suggesting that many cases are never diagnosed. While the exact cause of the condition is not known, the following factors have been suggested to possibly play a role in causing the condition in some cases:
- A history of abdominal surgery or trauma
- Having an autoimmune condition, including Riedel thyroiditis, primary sclerosing cholangitis, retroperitoneal fibrosis, and orbital pseudotumor, autoimmune hemolytic anemia, minimal change nephropathy, systemic lupus erythematosus, relapsing polychondritis, limited systemic sclerosis, or having elevated IgG4 in the blood and/or autoimmune pancreatitis
- Having an underlying cancer (paraneoplastic syndrome)
- History of infection