Increased levels of prostaglandin E-major urinary metabolite (PGE-MUM) in active mesenteric panniculitis patients

Abstract

Rationale:Mesenteric panniculitis (MP) is a rare disease with abdominal and systemic symptoms and is characterized by nonspecific inflammation, fat necrosis, and fibrosis in mesenteric fat. Active inflammatory responses may increase levels of prostaglandin E-major urinary metabolite (PGE-MUM), which was reported to reflect the disease activity of ulcerative colitis and chronic fibrosing interstitial pneumonia. We recently experienced a case with elevated PGE-MUM at the time of diagnosis of MP and we investigated the potential of PGE-MUM as a biomarker.Patient concern:In this report we described 2 active mesenteric panniculitis patients with high PGE-MUM levels.Diagnoses:Mesenteric panniculitisInterventions:Both MP patients were measured the levels of PGE-MUM.Outcomes:Both MP patients exhibited high levels of PGE-MUM before treatment. In one, the levels were sensitively correlated with clinical symptoms and serological markers on steroids.Lessons:The study observations suggest the potential of PGE-MUM to reflect the disease activity of MP. To verify its use, more findings based on clinical studies should be accumulated.

A case report of mesenteric panniculitis

“…CT diagnosis of MP is firmly established and based on five well-recognized pathognomonic features comprising the following: (1) a well-defined mass effect; (2) mesenteric fat tissue of higher inhomogeneous attenuation than that of adjacent intraabdominal fat; (3) small soft tissue nodules; (4) a halo sign; and (5) a pseudocapsule. 1–8,10 Our patient’s CT scan of the abdomen, which was performed with intravenous contrast material, showed the following. A mesenteric soft tissue mass (11.6 × 6.8 cm) was observed.…”

“…MP is also known as sclerosing mesenteric inflammation, mesenteric lipodystrophy, intestinal fat metabolism disorder, and mesenteric Weber-Christian disease. [1][2][3]5,6 MP was originally described by Jura in 1927 as a clinically rare mesenteric chronic inflammatory disease. Patients with MP have different clinical manifestations, such as bloating, nausea, vomiting, fever, weight loss, and loss of appetite.…”

“…2,8 MP is currently widely believed to be a benign, selflimiting inflammatory lesion, and it has a good prognosis, few recurrences after healing, and few serious complications. [1][2][3][4][5][6]10 There is no specific clinical treatment for MP. Surgical treatment for MP is not recommended because this disease causes extensive or localized mesenteric inflammatory changes, and locations close to large blood vessels are prone to recurrence after local ablation.…”

“…The cause of MP is unknown and may be due to abdominal surgery, trauma, ischemia, drugs, allergies, or autoimmune disease. [1][2][3][4] This disease can occur in any age group, but is more common in 50-to 60-year-olds, and the male to female ratio is 1.5 to 1.8:1.0. Patients with MP have different clinical manifestations and some patients with MP may experience no discomfort.…”

“…A few patients with MP present with an abdominal mass, peritonitis, peritoneal irritation, and ascites. [1][2][3] Diagnosis of MP is difficult and MP is easy to misdiagnose. Unfortunately, there is still no consistent diagnosis and no treatment guidelines.…”