Related Experiment Video
Updated: Jun 27, 2026
06:35
Sodium Taurocholate Induced Severe Acute Pancreatitis in C57BL/6 Mice
Published on: June 28, 2021
Pancreatitis, panniculitis, and polyarthritis.
Javier Narváez1, Maria Marta Bianchi, Pilar Santo
1Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain. 31577edd@comb.es
Seminars in Arthritis and Rheumatism
|December 17, 2008
Summary
The pancreatitis, panniculitis, and polyarthritis (PPP) syndrome, a rare complication of pancreatic disease, presents with joint and skin inflammation. Early recognition of underlying pancreatic issues is crucial for patient survival and effective treatment.
Area of Science:
- Rheumatology
- Gastroenterology
- Dermatology
Background:
- Lobular panniculitis, polyarthritis, and intraosseous fat necrosis can manifest as a rare complication of pancreatic disease, known as the pancreatitis, panniculitis, and polyarthritis (PPP) syndrome.
- This syndrome highlights the complex interplay between pancreatic exocrine function and systemic inflammatory processes.
Observation:
- A case of PPP syndrome is presented, featuring extensive intraosseous fat necrosis visualized via MRI.
- Literature review identified 25 documented cases, revealing that nearly two-thirds of patients exhibit minimal or absent abdominal symptoms, often leading to diagnostic delays.
Findings:
- Despite high pancreatic enzyme levels, the index patient reported mild abdominal symptoms.
- A significant proportion of patients (nearly 45%) experience chronic arthritis unresponsive to standard treatments, with rapid radiographic joint damage.
- The overall mortality rate for untreated or misdiagnosed PPP syndrome reaches 24%.
Implications:
- Physicians must maintain a high index of suspicion for PPP syndrome in patients presenting with unexplained panniculitis and polyarthritis.
- Prompt diagnosis and management of the underlying pancreatic disease are critical to prevent fatal outcomes and avoid ineffective, potentially harmful treatments for joint symptoms.
Related Concept Videos
01:25Acute Pancreatitis I: Introduction
Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
01:27Acute Pancreatitis I: Introduction
Pancreatitis is inflammation of the pancreas, an organ located behind the stomach. It can be either acute or chronic.
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:21Acute Pancreatitis II: Pathophysiology
The pathophysiology of acute pancreatitis centers on injury to pancreatic acinar cells, which initiates a cascade of harmful intracellular events.This injury leads to premature activation of trypsinogen to trypsin in the pancreas. Trypsin then activates other digestive enzymes, such as chymotrypsin, elastase, and phospholipase A2, which begin breaking down pancreatic tissue. The resulting autodigestion causes local inflammation, tissue swelling, hemorrhage, and fat necrosis.Injured acinar cells...
01:24Chronic Pancreatitis I: Introduction
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:25Chronic Pancreatitis I: Introduction
Chronic pancreatitis is a long-standing, relapsing inflammation of the pancreas, characterized by irreversible damage to the gland. It results in progressive destruction of the pancreatic parenchyma, fibrosis, and eventual loss of both exocrine and endocrine function. The disease may evolve gradually after multiple episodes of acute pancreatitis or develop independently.EtiologyChronic pancreatitis can arise from a variety of causes:Alcohol use is the leading cause, accounting for 70–80% of...
01:21Chronic Pancreatitis II: Pathophysiology
Chronic pancreatitis is a progressive and irreversible inflammation of the pancreas, most often caused by long-term alcohol abuse, but it can also be related to ductal obstruction, smoking, or genetic factors.Chronic pancreatitis occurs when the pancreas is repeatedly exposed to harmful agents like alcohol, smoking, ductal obstruction, or genetic predisposition. These factors lead to the release of toxic metabolites and inflammatory cytokines, sustaining chronic inflammation in the pancreatic...