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Mesenteric panniculitis presenting as fever of unknown origin
1Service of Gastroenterology, Hospital Clínic i Provincial, Barcelona, Spain.
The American Journal of Gastroenterology
|July 1, 1995
Summary
This case study highlights mesenteric panniculitis, a rare inflammatory condition, presenting unusually with prolonged fever of unknown origin. The patient showed initial response to steroids but later experienced recurring symptoms, indicating complex disease management.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pathology
Background:
- Mesenteric panniculitis is a rare, benign condition characterized by inflammation of the mesenteric adipose tissue.
- Common symptoms include abdominal pain, weight loss, and palpable abdominal mass.
- High fever and leukocytosis are atypical presentations.
Observation:
- A 40-year-old male presented with prolonged fever of unknown origin.
- Diagnostic imaging (ultrasound, CT, MRI) suggested mesenteric panniculitis.
- Laparoscopy confirmed the diagnosis via retroperitoneal mass biopsy.
Findings:
- This is one of the few reported cases of mesenteric panniculitis presenting as fever of unknown origin.
- The patient initially responded to steroid therapy (prednisone).
- Subsequent addition of azathioprine did not prevent disease recurrence and persistent symptoms.
Implications:
- Mesenteric panniculitis, though rare, should be considered in the differential diagnosis of fever of unknown origin, especially with atypical presentations.
- Management of mesenteric panniculitis can be challenging, with potential for relapsing disease despite immunosuppressive therapy.
- Further research is needed to understand the pathophysiology and optimize treatment strategies for this uncommon condition.