Multiple Mesenteric Panniculitis as a Complication of Sj&amp;ouml;gren's Syndrome Leading to Ileus

Kakimoto, Kazuki; Inoue, Takuya; Toshina, Ken; Yorifuji, Naoki; Iguchi, Munetaka; Fujiwara, Kaori; Kojima, Yuichi; Okada, Toshihiko; Nouda, Sadaharu; Kawakami, Ken; Abe, Yosuke; Takeuchi, Toshihisa; Egashira, Yasuyuki; Higuchi, Kazuhide

doi:10.2169/internalmedicine.55.5407

Cited by 3 publications

(3 citation statements)

References 14 publications

(13 reference statements)

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“…However, SS is rarely associated with this condition, with less than 10 reported cases in the literature [3][4][5][6]. The majority of reported patients with mesenteric panniculitis needed treatment (corticosteroids and other immunosuppressants, or even surgery) as they were symptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…This condition can present as abdominal pain, obstruction, weight loss or, in most cases, may be asymptomatic [1] . Primary Sjögren's syndrome (SS) is an autoimmune disease mainly known for lymphocytic infiltration of the secretory glands (xerostomia and xerophthalmia, also called DEMS (dry eyes and mouth syndrome), is the common presentation), but it can occur with systemic manifestations like interstitial lung disease, Raynaud's phenomenon and arthritis [2] or, in rare cases, mesenteric panniculitis [3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

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Mesenteric Panniculitis in Sjögren’s Syndrome: A New Systemic Manifestation to Consider?

Mendes

Ferreira

Temido

et al. 2018

European Journal of Case Reports in Internal Medicine

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The association between mesenteric panniculitis and Sjögren’s syndrome, although rare, is starting to be recognized. Usually, mesenteric panniculitis is symptomatic, presenting with either general or gastrointestinal symptoms. Sjögren’s syndrome is an autoimmune disease that typically affects secretory glands, but may have serious systemic involvement. We report the case of a 77-year-old patient in whom accidental discovery of asymptomatic mesenteric panniculitis on computed tomography led to the diagnosis of Sjögren’s syndrome with several systemic manifestations. LEARNING POINTS Mesenteric panniculitis is a rare condition, sometimes associated with autoimmune diseases, which can make the differential diagnosis with more frequent systemic diseases difficult. There is no specific treatment for mesenteric panniculitis, but it is agreed that only symptomatic patients should be treated. Although Sjögren’s syndrome typically presents with xerostomia and xerophthalmia (dry eyes and mouth syndrome, DEMS), it should always be kept in mind that systemic manifestations can occur, especially in more severe cases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mesenteric Panniculitis in Sjögren’s Syndrome: A New Systemic Manifestation to Consider?

Mendes

Ferreira

Temido

et al. 2018

European Journal of Case Reports in Internal Medicine

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“…Провоцирующими факторами развития МПн могут быть травма или хирургическое вмешательство, тепловые или химические повреждения, нарушения в системе свертывания, изменения сосудистой стенки, поражение желудочно-кишечной и сердечно-сосудистой систем, ожирение, развитие онкологической патологии, влияние бактериальной инфекции, курения и наркотиков [1-4, 13, 14]. Имеется незначительное число описаний МПн при синдроме Шегрена [15], системной красной волчанке [16], системном склерозе [17], ревматоидном артрите (РА) [18], анкилозирующим спондилите [19], Мф ИЛПн [20,21] и IgG4-связанном заболевании (IgG4-CB) [22]. Истинная клиническая и прогностическая значимость МПн при ревматических заболеваниях остается недооцененной.…”

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Mesenteric panniculitis in rheumatologist practice

Егорова¹,

Datsina

2023

Sovremennaâ revmatologiâ

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Mesenteric panniculitis (MPn) is a rare form of adipose tissue inflammation, mainly of the intestinal mesentery, less often of the omentum, preand retroperitoneal tissue. There are not many descriptions of MPn in rheumatic diseases in the literature: in systemic lupus erythematosus, systemic sclerosis, Sjogren's syndrome, rheumatoid arthritis (RA), ankylosing spondylitis, mesenteric form (MF) of idiopathic lobular panniculitis (ILPn) and IgG4-related disease (IgG4-RD). Given the polymorphism of clinical manifestations, including systemic ones, it is of interest to look at the problem of MPn from the perspective of a rheumatologist.Objective: to evaluate the clinical and laboratory features of MPn in modern rheumatological practice.Material and methods. The study included 64 patients (19 men and 45 women aged 19 to 76 years, median disease duration 28.6 [0.3; 243] months). Laboratory and instrumental studies were carried out according to a single algorithm, which included standard clinical, immunological methods, as well as the determination of fecal calprotectin and tumor markers, ultrasound of the skin and subcutaneous adipose tissue (SAT), computed tomography of the chest and abdominal organs, abdominal positron emission tomography, pathomorphological examination of biopsies of the skin, pancreas and mesentery.Results and discussion. 89% of patients had abdominal pain, 48.4% had nausea, 53.1% had weakness, 44% had subfebrile fever, 32.8% had articular syndrome, and 29.6% – skin and pancreas involvement. Median ESR was 34 [11; 52] mm/h, CRP level – 14 [2; 72] mg/l. Most of the immunological parameters remained within the normal range, but in some cases there was an increase in the concentration of rheumatoid factor, antibodies to the cyclic citrullinated peptide, IgG4. The level of tumor markers CA 125, CEA, CA 19–9 and TumorM2-PK was increased 2 times or more in 5 patients. In our study, all radiological signs and all degrees of severity of MPn were observed. An additional examination confirmed the presence of MF ILPn, RA, IgG4-RD, gastrointestinal, malignant, hematological and other diseases, which made it possible to identify five diagnostic blocks.Conclusion. Early diagnosis and correct interpretation of the described changes require a lot of work-up and a multidisciplinary approach, which contributes to accurate and timely recognition of the disease.

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Associations rares ou trompeuses entre pathologies articulaires et pathologies hépato-gastro-entérologiques

Berthelot

2018

Revue du Rhumatisme Monographies

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Multiple Mesenteric Panniculitis as a Complication of Sjögren's Syndrome Leading to Ileus

Cited by 3 publications

References 14 publications

Mesenteric Panniculitis in Sjögren’s Syndrome: A New Systemic Manifestation to Consider?

Mesenteric Panniculitis in Sjögren’s Syndrome: A New Systemic Manifestation to Consider?

Mesenteric panniculitis in rheumatologist practice

Associations rares ou trompeuses entre pathologies articulaires et pathologies hépato-gastro-entérologiques

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