‘Pancreatitis, polyarthritis, panniculitis syndrome’ (PPP syndrome) plus prolonged pyrexia-a rare presentation of chronic pancreatitis

Abstract

Pancreatitis presenting without abdominal pain is very unusual. Here we report a 70-year-old man with chronic calcific pancreatitis presented to us with prolonged fever, arthritis and multiple subcutaneous swellings, but without any abdominal pain or other abdominal symptoms. His serum amylase and lipase were very high. Biopsy from the subcutaneous swellings revealed fat necrosis and CT scan abdomen showed features of chronic calcific pancreatitis. He was managed conservatively with supportive measures, and recovered. There is only scanty information in literature regarding this type of presentation in chronic pancreatitis.

Pancreatitis, panniculitis and polyarthritis (PPP-) syndrome caused by post-pancreatitis pseudocyst with mesenteric fistula. Diagnosis and successful surgical treatment. Case report and review of literature

“…Causative treatment depends on the underlying pancreatic disease and involves handling of acute or chronic pancreatitis, pancreatic duct stenosis, EUS-guided cyst-gastrostomy and surgical resection of pseudocysts [1] , [6] , [7] , [9] , [22] , [24] . Of particular relevance are the surgical dissection or even segmental resection and reconstruction of the mesenteric or portal veins in order to reliably remove the fistula, which drains the pancreatic juice into the portal blood stream.…”

Pancreatic disease, panniculitis, polyarthrtitis syndrome successfully treated with total pancreatectomy: Case report and literature review

“…In literature 64 cases of PPP syndrome are reported, 34 patients with pancreatitis [2] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , 30 patients with pancreatic cancer [3] ( Table 1 ).…”

A case report of pancreatitis-panniculitis-polyarthritis syndrome – an unusual but serious presentation of pancreatic disease

“…10 Dermatological lesions typically disappear with clinical improvement and resolution of subjacent pancreatitis. 17,18 Arthralgia is the leading symptom affecting 25% of patients with PPP triad. 4 It usually presents as symmetric or asymmetric polyarthritis involving small and large joints.…”

“…10 Dermatological lesions typically disappear with clinical improvement and resolution of subjacent pancreatitis. 17,18…”