| Pancreatitis, panniculitis, and polyarthritis. | |
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MedLine Citation:
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PMID: 19070353 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: Lobular panniculitis, together with polyarthritis and intraosseous fat necrosis, may occasionally complicate pancreatic disease. This triad is known in the literature as the pancreatitis, panniculitis, and polyarthritis (PPP syndrome). We describe a case of the PPP syndrome and review the available literature to summarize the clinical characteristics of patients with this condition. METHODS: A patient with the PPP syndrome, with evidence of extensive intraosseous fat necrosis in the joints involved revealed by magnetic resonance imaging, is described and the relevant literature based on a PubMed search from 1970 to February 2008 is reviewed. The keywords used were pancreatitis or pancreatic disease, panniculitis, arthritis, and intraosseous fat necrosis. RESULTS: Including our case, 25 well-documented patients with the PPP syndrome have been reported. Our patient had few abdominal symptoms despite high serum levels of pancreatic enzymes. In our review of the literature, almost 2/3 of patients had absent or mild abdominal symptoms, leading to misdiagnosis. The delay in diagnosis and specific treatment of the underlying pancreatitis worsens the prognosis of this condition, which has a mortality rate as high as 24%. In nearly 45% of the patients, the arthritis follows a chronic course with a poor response to nonsteroidal anti-inflammatory drugs and corticosteroids, and the rapid development of radiographic joint damage. CONCLUSION: Certain forms of pancreatic disease can very occasionally cause arthritis and panniculitis. Although uncommon, physicians should be alert to the possible presence of this syndrome for 2 reasons: first, unrecognized pancreatic disease can be fatal if not treated promptly; second, to avoid inappropriate and risky therapy to improve joint symptoms. |
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Authors:
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Javier Narváez; Maria Marta Bianchi; Pilar Santo; Diana de la Fuente; Valeria Ríos-Rodriguez; Ferran Bolao; José Antonio Narváez; Joan Miquel Nolla |
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Publication Detail:
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Type: Case Reports; Journal Article; Review Date: 2008-12-13 |
Journal Detail:
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Title: Seminars in arthritis and rheumatism Volume: 39 ISSN: 1532-866X ISO Abbreviation: Semin. Arthritis Rheum. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-23 Completed Date: 2010-08-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1306053 Medline TA: Semin Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 417-23 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain. 31577edd@comb.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arthritis
/
diagnosis*,
pathology,
therapy Arthrography Fat Necrosis / diagnosis, pathology Humans Joints / pathology Magnetic Resonance Imaging Male Middle Aged Pancreas / enzymology Pancreatitis / diagnosis*, pathology, therapy Panniculitis / diagnosis*, pathology, therapy Syndrome Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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