Granulomatous mastitis, erythema nodosum, and arthritis syndrome: a narrative review

GMENA appears to represent a distinct clinicopathologic entity within the spectrum of IGM, characterized by the triad of granulomatous mastitis, EN, and frequently acute oligoarthritis in women of childbearing age. The available evidence supports an underlying immune-mediated mechanism and favors systemic corticosteroids, with early introduction of steroid-sparing immunosuppressants in refractory or relapsing disease. Antibiotics and extensive surgery have limited roles. Further prospective and mechanistic studies are needed to clarify pathogenesis and to optimize long-term management strategies.