biology

Idiopathic sclerosing mesenteritis

Idiopathic sclerosing mesenteritis is a biology topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Idiopathic sclerosing mesenteritis rather than just read about it. In short: Idiopathic sclerosing mesenteritis (ISM) is a rare disease of the small intestine, characterized by chronic inflammation and eventual fibrosis of the mesentery. It has also been called mesenteric lipodystrophy, or retractile mesenteritis.

Key takeaways

Idiopathic sclerosing mesenteritis belongs to biology; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Idiopathic sclerosing mesenteritis to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Idiopathic sclerosing mesenteritis from memory before moving on to harder problems.

Reference excerpt

Idiopathic sclerosing mesenteritis (ISM) is a rare disease of the small intestine, characterized by chronic inflammation and eventual fibrosis of the mesentery. It has also been called mesenteric lipodystrophy, or retractile mesenteritis.

Signs and symptoms Sclerosing mesenteritis may present with no or nearly no signs or symptoms, but many people have chronic and severe pain in the abdomen as the most common chief complaint. Other people have chronic problems with bowel movements, resulting in diarrhea, bloating, gas, and cramping which can range from severe to mild.The disorder is identified by histopathology showing fat necrosis, fibrosis and chronic inflammation of the small intestine. Examination of the mesentery may indicate a solitary mass, but diffuse mesentery thickening is common.

Mechanism Several causes of sclerosing mesenteritis have been suggested such as trauma, prior surgical procedures, autoimmune diseases such as lupus, IgG4-related disease, rheumatoid arthritis, infections such as tuberculosis, cryptococcosis, schistosomiasis, HIV and medicines such as paroxetine and pergolide but their associations with sclerosing mesenteritis are largely speculative with high degree of bias.

Diagnosis

In regards to the diagnosis of idiopathic sclerosing mesenteritis, a CT scan which creates cross-section pictures of the affected individuals body, can help in the assessment of the disease. "Misty mesentery" is often used to describe increase in mesenteric fat density in sclerosing mesenteritis. However, it is not specific and can be found in other conditions such as mesenteric oedema, lymphedema, haemorrhage, and presence of neoplastic and inflammatory cells must be excluded. Mesenteric lymph nodes are rarely larger than 10 mm in sclerosing mesenteritis. Larger lymph nodes should prompt further investigations with PET scan or biopsy.MRI scan may show an intermediate T1 intensity and variable T2 intensity depending on degree of oedema and fibrosis. Presence of oedema causes high T2 signal while fibrosis causes low T2 signal.

Differential diagnosis It often mimics other abdominal diseases such as pancreatic or disseminated cancer. CT scanning is important for making the initial diagnosis.

Treatment In terms of possible treatment for the condition of idiopathic sclerosing mesenteritis, medications such as corticosteroids, tamoxifen and thalidomide have been used.

Epidemiology The epidemiology of Idiopathic sclerosing mesenteritis disease is extremely rare and has only been diagnosed in about an estimated 300 patients worldwide to date (as of 2014), it is probably under diagnosed. It can occur in children.

Research

The Mayo Clinic in Rochester reported a large study of 92 patients, with widely ranging severity of their symptoms. The majority were male, with an average age of 65 years. They commonly had abdominal pain (70%), diarrhea (25%), and weight loss (23%). Depending on the stage of the scarring and fibrosis, several different treatments, including surgery for bowel obstruction, or drugs were used to halt the progression of the disease. In that case series, 56% of patients received only pharmacological therapy, most often receiving tamoxifen with a reducing dose of reducing prednisone, or also had colchicine, azathioprine or thalidomide. Their findings suggest that sclerosing mesenteritis can be debilitating although relatively benign. Symptomatic patients benefited from medical therapy, usually tamoxifen and prednisone, but further follow-up information would strengthen these results.

See also Small intestine and the abdomen

References

Further reading Federle, Michael P.; Raman, Siva P. (2015-07-29). Diagnostic Imaging: Gastrointestinal. Elsevier Health Sciences. ISBN 9780323400404. Vlachos, Konstantinos; Archontovasilis, Fotis; Falidas, Evangelos; Mathioulakis, Stavros; Konstandoudakis, Stefanos; Villias, Constantinos (2011-06-02). "Sclerosing Mesenteritis: Diverse clinical presentations and dissimilar treatment options. A case series and review of the literature". International Archives of Medicine. 4: 17. doi:10.1186/1755-7682-4-17. ISSN 1755-7682. PMC 3128041. PMID 21635777. Issa, Iyad; Baydoun, Hassan (14 August 2009). "Mesenteric panniculitis: Various presentations and treatment regimens". World Journal of Gastroenterology. 15 (30): 3827–3830. doi:10.3748/wjg.15.3827. ISSN 1007-9327. PMC 2726466. PMID 19673029.

External links

Illustrations

Worked examples

Example 1 — a first encounter with Idiopathic sclerosing mesenteritis

Start with the simplest possible case. Write down what Idiopathic sclerosing mesenteritis claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In biology, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Idiopathic sclerosing mesenteritis before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Idiopathic sclerosing mesenteritis ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Idiopathic sclerosing mesenteritis

In research: Idiopathic sclerosing mesenteritis appears in biology research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Idiopathic sclerosing mesenteritis in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Idiopathic sclerosing mesenteritis is common in secondary-school and first-year university syllabi. It links to neighbouring topics Diseases of intestines, IgG4-related disease, Rare diseases, so understanding it makes those chapters shorter.
In everyday life: Look for Idiopathic sclerosing mesenteritis outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Idiopathic sclerosing mesenteritis in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Idiopathic sclerosing mesenteritis means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Idiopathic sclerosing mesenteritis out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Idiopathic sclerosing mesenteritis in simple terms?

Why does Idiopathic sclerosing mesenteritis matter?

Because it connects several biology ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Idiopathic sclerosing mesenteritis?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Idiopathic sclerosing mesenteritis.