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Aggressive multiple myeloma presenting as mesenteric panniculitis.

J Goh1, B Otridge, H Brady

  • 1Department of Gastroenterology, Mater Misericordiae Hospital and University College, Dublin, Ireland.

The American Journal of Gastroenterology
|February 24, 2001
PubMed
Summary

Mesenteric panniculitis, a rare bowel condition, can sometimes mask aggressive hematological malignancies. This case highlights a patient initially diagnosed with mesenteric panniculitis who later developed IgA kappa chain myeloma.

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Area of Science:

  • Gastroenterology and Oncology
  • Pathology and Immunology

Background:

  • Mesenteric panniculitis is a rare idiopathic inflammatory condition of the bowel mesentery.
  • It typically presents with abdominal pain or fever and has a generally benign prognosis.

Observation:

  • A 43-year-old male presented with malaise, weight loss, microcytic anemia, and elevated erythrocyte sedimentation rate.
  • Radiographic and histological findings confirmed mesenteric panniculitis, which initially responded well to high-dose oral prednisolone.

Findings:

  • The patient relapsed within six months with anemia, renal failure, and hypercalcemia.
  • A diagnosis of IgA kappa chain myeloma was established.
  • This case represents the first documented instance of a hematological malignancy initially presenting as mesenteric panniculitis with a fatal outcome.

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Implications:

  • Mesenteric panniculitis may be an initial manifestation of underlying hematological malignancies.
  • Further investigation is warranted for patients with unexplained or recurrent mesenteric panniculitis.
  • This case underscores the importance of considering systemic diseases in the differential diagnosis of mesenteric panniculitis.