Unusual presentation of pancreatitis with extrapancreatic manifestations

Unusual presentation of pancreatitis with extrapancreatic manifestations

Pancreatitis, panniculitis and polyarthritis syndrome (PPP syndrome) is a rare and complex manifestation of pancreatitis that is currently reported in few cases. We present this case regarding a 77-year-old man who presented unusually with a 6-week history of bilateral lesions on his lower limbs. Du...

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Bibliographic Details
Published in:BMJ case reports Vol. 2018; p. bcr-2018-226440
Main Authors: Fordham, Tony, Sims, Helen Marie, Farrant, Terence
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 15-09-2018
BMJ Publishing Group
Series:Case Report
Subjects:
Abdomen
Adipocytes
Aged
Arthralgia - etiology
Arthritis
Arthritis - complications
Case reports
Cysts
Endoscopy
Family medical history
Fat Necrosis - etiology
Finger Joint
Gangrene
Histology
Hospitals
Humans
Inflammation
Leg
Male
Medical imaging
Pain
Pancreas
Pancreatitis
Pancreatitis - complications
Panniculitis - complications
Patients
Rare Disease
Rheumatism
Syndrome
Ultrasonic imaging
South Africa
pancreas and biliary tract
pancreatitis
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Summary:Pancreatitis, panniculitis and polyarthritis syndrome (PPP syndrome) is a rare and complex manifestation of pancreatitis that is currently reported in few cases. We present this case regarding a 77-year-old man who presented unusually with a 6-week history of bilateral lesions on his lower limbs. During this time, he experienced increasing fatigue, joint pain, and reported fevers and significant weight loss. An incidental serum amylase was found to be significantly elevated and remained elevated throughout his 2-month hospital stay. He never complained of abdominal pain or other typical symptoms of pancreatitis. Histological examination of the leg lesions reported evidence of fat necrosis and changes consistent with pancreatic panniculitis. An abdominal CT scan revealed a well-defined lesion posterior to the neck of the pancreas. Further examination by endoscopic ultrasound revealed chronic inflammatory changes. The patient experienced a long admission and was managed supportively until he was well enough to be discharged home.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
ObjectType-Article-3
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-226440