What is the diagnosis and treatment for Chronic Mesenteric Panniculitis (Sclerosing Mesenteritis)?

From the Research

Chronic mesenteric panniculitis should be treated with corticosteroids, such as prednisone, as the first line of therapy, with a gradual taper over 3-6 months, depending on symptom response, as supported by the most recent study 1. The diagnosis of chronic mesenteric panniculitis is typically made based on computed tomography (CT scan) with IV contrast and biopsies in equivocal cases, as stated in the study 1. Key points to consider in the treatment of chronic mesenteric panniculitis include:

• The use of corticosteroids, such as prednisone, as the primary treatment, with a starting dose of 40-60mg daily, as mentioned in the example answer.
• The potential addition of immunomodulators, such as azathioprine or methotrexate, for steroid-sparing therapy, as noted in the example answer.
• The use of NSAIDs, such as ibuprofen or naproxen, to manage pain and inflammation, as stated in the example answer.
• The consideration of colchicine, tamoxifen, or other therapies in specific cases, as mentioned in the study 2.
• Regular monitoring with CT scans every 6-12 months to assess disease progression and treatment response, as recommended in the example answer.
• The importance of individualizing treatment based on symptom severity, with mild cases sometimes requiring only observation, as noted in the example answer. The most recent and highest quality study, 1, provides the best evidence for the treatment of chronic mesenteric panniculitis, and its findings should be prioritized in clinical decision-making. Other studies, such as 3, 4, and 2, provide additional information on the diagnosis and treatment of chronic mesenteric panniculitis, but are not as recent or of the same quality as 1. The study 5 is older and provides less relevant information for current clinical practice. In summary, the treatment of chronic mesenteric panniculitis should be guided by the most recent and highest quality evidence, with a focus on corticosteroids as the first line of therapy, and individualized based on symptom severity and patient response.