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[A 55-year-old man with abdominal pain and fever]

A Hahnel1, N Zitzler, K Schardt

  • 1Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, Regensburg, Deutschland.

Der Internist
|September 13, 2013
PubMed

Insights

Mesenteric panniculitis, a rare condition causing abdominal pain, was diagnosed in a patient with IgG kappa plasmacytoma. Steroid treatment provided rapid symptom relief, highlighting its role in managing this paraneoplastic syndrome.

Area of Science:

  • Gastroenterology
  • Oncology
  • Pathology

Background:

  • Mesenteric panniculitis is a rare, benign inflammatory condition of the small intestine mesentery.
  • It can present with chronic abdominal pain, fever, and weight loss.
  • Often associated with malignancy, it is considered a paraneoplastic syndrome.

Observation:

  • A 55-year-old man presented with chronic abdominal pain and fever.
  • Computed tomography revealed a retroperitoneal inflammatory process involving the mesenteric root.
  • Adipose tissue biopsy confirmed mesenteric panniculitis with granulomas.

Findings:

  • Further investigations diagnosed the patient with plasmacytoma type IgG kappa.
  • Treatment with prednisolone (steroids) led to immediate improvement in pain and fever.
  • Mesenteric panniculitis was identified as a paraneoplastic syndrome linked to non-Hodgkin lymphoma.

Implications:

  • This case underscores the importance of considering paraneoplastic syndromes in patients with mesenteric panniculitis.
  • Early diagnosis and management of the underlying malignancy are crucial for patient outcomes.
  • Steroid therapy can be effective in alleviating symptoms associated with mesenteric panniculitis.

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