A Case-control Study Of Antipsychotic-associated Mastitis

Objective:The study compares the general information,clinical conditions and treatment conditions of antipsychotic drug-related mastitis with granulomatous lobular mastitis(GLM)and plasma cell mastitis(PCM).Discuss the similarities and differences in etiology,pathogenesis,clinical manifestations,auxiliary examination and treatment between antipsychotic drug-related mastitis and general non-lactating mastitis,and provide reasonable suggestions for the current diagnosis and treatment of antipsychotic drug-related mastitis.Methods:A retrospective analysis of the previous confirmed diagnosis of mental illness through the method of case-control study,long-term use of antipsychotic drugs and then discontinuation of the drug,or continuous use of antipsychotic drugs,and suffering from mastitis after taking antipsychotic drugs,and in 2013 As of October 2020,he was diagnosed as a case of non-lactating mastitis in the outpatient or hospitalization of our department.At the same time,the patients who had no history of psychiatric diseases and were diagnosed as non-lactating mastitis at the same time and visited our department at the same time were compared and studied,including the control group of granulomatous lobular mastitis and the control group of plasma cell mastitis.Compare and study the similarities and differences in general conditions,clinical manifestations,auxiliary examinations and treatments of the three groups of patients.Statistical software uses SPSS21.0 for analysis.Result:A total of 60 patients were enrolled,including 20 cases in the antipsychotic drug-associated mastitis case group,20 cases in the granulomatous lobular mastitis control group(GLM control group),and 20 cases in the plasma cell mastitis control group(PCM control group).1.General situation:In the case group of 20 patients,14 patients(70%)took a single antipsychotic drug,5 patients(25%)took two antipsychotics,and three antipsychotics were combined.One patient(5%)took it.Oral drugs were mainly risperidone,clozapine,sulpiride,thioridazine hydrochloride,etc.There was no statistical difference in the age of onset,season of onset,out-of-hospital treatment,and past medical history except for mental illness(p>0.05).2.Clinical manifestations:The number of breast lumps in the case group ranged from 0 to 3,3 cases(15%)without breast lumps,11 cases(55%)with single breast lumps,2 breasts There were 4 cases of lumps(20%),and 1 case of 3 breast lumps(5%);in the GLM control group,19 cases(95%)of a single breast lumps,in the PLM control group There were 19 cases(95%)of a single breast mass.The comparison between the three data groups showed that the p value was less than 0.05,which was statistically significant.Three groups of patients were admitted to the hospital with cases of nipple deformities,and the main cases were inverted nipples and split nipples.In the case group,there were 17 patients with nipple deformities,24 times,inverted nipples(accounting for 54.17%),split nipples(accounting for 37.5%);16 cases of nipple deformities in the GLM control group,22 times,and 12 inverted nipples(accounted for 54.55%),7 times of nipple splitting(31.82%);18 cases of nipple deformities in the PCM control group,26 times,of which 12 times(46.15%)were inverted nipple,11 times(42.31%)were split.In terms of prolactin level:11 patients in the case group were abnormally elevated when they were admitted to the hospital,and the abnormal prolactin level was between 652.6-2845?IU/ml,with an average of 1060.96±622.89?IU/ml.The other two groups of patients maintained prolactin.normal level.In terms of treatment course,among the 20 patients in the case group,the shortest course of treatment was 39 days,the longest course of treatment was 189 days,with an average of 88.7±32.61 days;the GLM control group had the shortest course of treatment of 10 days and the longest course of treatment of 273 days,with an average of 77.8±61.61 days;the shortest course of treatment for the PCM control group was 13 days,the longest course of treatment was 191 days,and the average was 77.75±60.78 days.Analyzing the length of treatment in the three groups,the difference between the three groups was p<0.05,which was statistically significant.Conclusion:Antipsychotic drug-associated mastitis has no special difference from general non-lactating mastitis in terms of age of onset and season of onset,but in terms of clinical manifestations,antipsychotic drug-associated mastitis is compared with general non-lactating mastitis Mastitis is clearly different from granulomatous lobular mastitis and plasma cell mastitis in terms of the size of the tumor,whether the site of the disease includes the nipple and areola area,the level of prolactin,and the course of treatment.It is considered that the cause of antipsychotic drug-associated mastitis is significantly different from the two.In terms of traditional Chinese medicine treatment,in addition to syndrome differentiation and treatment of traditional Chinese medicine treatment of antipsychotic drug-associated mastitis,the combination of Jiaoshanzha and Stir-Fried Malt can also effectively reduce the level of prolactin.However,the two control groups in this study are both in the with normal prolactin levels,there are only 11 patients in the case group with high prolactin levels.Therefore,the effectiveness and safety evaluation of the drug combination to reduce prolactin levels needs to be verified by subsequent prospective studies.