Mesenteric Panniculitis: An Unusual Initial Presentation Of Systemic Lupus Erythematosus (SLE)
Mesenteric Panniculitis: An Unusual Initial Presentation Of Systemic Lupus Erythematosus (SLE)
复制标题
肠系膜脂膜炎：系统性红斑狼疮 (SLE) 的一种不寻常的初始表现
DOI：
10.5580/bc5
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
P. Chadha
中科院分区：
文献类型：
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作者：
Deepak Pahuja;Manoharan W. Eustace;P. Chadha
简介：系统性红斑狼疮患者会出现多种症状和主诉，炎症过程几乎会影响每个器官。最常见的疾病模式是皮肤、肌肉骨骼、血液学和血清学受累的全身症状的混合。肠系膜脂膜炎是一种影响肠系膜脂肪组织的罕见疾病，可能导致腹部出现大肿块。弥漫性慢性或间歇性腹痛是最常见的症状。文献检索：我们使用脂膜炎作为主题词、腹膜和肠系膜脂膜炎作为附加关键词进行了 Medline 检索。搜索结果为 142 篇文章。将此搜索与我们对系统性红斑狼疮的第二次搜索相结合，在一本法国杂志上只得出了一个结果，该结果是一名 10 岁女孩患有肠系膜脂膜炎，作为急性红斑狼疮的首发表现。病例：我们描述了一名 44 岁女性，患有一年来反复腹痛，且既往病史阴性。她接受了腹腔镜检查以明确诊断腹痛。手术时发现乳糜腹水，随后的开腹剖腹手术显示肠系膜坏死区域。活检结果显示脂肪坏死，腹部 CT 扫描显示脂膜炎的典型特征。该患者随后出现盗汗、发热、下肢皮疹、左手近端咽间关节疼痛、肿胀、活动范围减小以及血小板减少。她还抱怨眼睛和耳朵干燥。随后的检查显示，她呈 ANA 阳性，滴度为 1:1280，呈斑点状，SSA 和 SSB 抗体呈阳性。皮肤活检显示白细胞破碎性血管炎。此外，她还有两次流产史。她被诊断患有系统性红斑狼疮，表现为继发性干燥症和特发性血小板减少症，并开始接受口服皮质类固醇治疗，效果良好。结论：系统性红斑狼疮必须包含在腹内脂膜炎的病因中。
Introduction: Patients with SLE are subject to a myriad of symptoms and complaints, and the inflammatory process can affect virtually every organ. The most common pattern of disease is a mixture of constitutional complaints with skin, musculoskeletal, hematological and serologic involvement. Mesenteric panniculitis is a rare disease affecting adipose tissue of the mesentery that may result in the development of large masses in the abdomen. Diffuse chronic or intermittent abdominal pain is the most frequent symptom. Literature Search: We performed a Medline search using panniculitis as subject heading and peritoneal and mesenteric panniculitis as additional keywords. The search yielded 142 articles. Combining this search with our second search on Systemic Lupus Erythematosus yielded only one result in a French journal of a 10 year girl with mesenteric panniculitis as initial presentation of acute lupus erythematosus. Case: We describe a 44 year old female with one year of recurrent abdominal pain and an otherwise negative past medical history. She underwent a laparoscopy for definite diagnosis of her abdominal pain. At surgery, chylous ascites was noted and a subsequent open laparotomy showed necrotic areas in the mesentery. Biopsy results revealed fat necrosis and an abdominal CT scan showed classic features of panniculitis. This patient later presented with night sweats, fever, lower extremity rash, pain in the proximal interphalyngeal joints of her left hand with swelling and decrease in range of motion and thrombocytopenia. She also complained of dryness in her eyes and ears. Subsequent workup revealed she was ANA positive with a titer of 1:1280 in a speckled pattern and positive SSA and SSB antibody. Skin biopsy showed leukocytoclastic vasculitis. In addition she had a history of two miscarriages. She was diagnosed as having systemic lupus erythematosus manifesting with secondary sjogren's and idiopathic thrombocytopenia, and was started on oral corticosteroid treatment with excellent response. Conclusion: Systemic lupus erythematosus must be included among the etiologies of intraabdominal panniculitis.