胰腺性脂膜炎——急性胰腺炎的一种皮肤表现。
Pancreatic panniculitis - a cutaneous manifestation of acute pancreatitis.
作者信息
Laureano André, Mestre Tiago, Ricardo Leonel, Rodrigues Ana Maria, Cardoso Jorge
机构信息
Department of Dermatology and Venereology, Hospital de Curry Cabral - Centro Hospitalar de Lisboa Central, Lisboa, Portugal;
Department of Gastroenterology, Hospital Fernando da Fonseca, Amadora, Portugal.
出版信息
J Dermatol Case Rep. 2014 Mar 31;8(1):35-7. doi: 10.3315/jdcr.2014.1167.
BACKGROUND
Pancreatic panniculitis is a rare complication of pancreatic disease occurring in 2% to 3% of all patients, most commonly those with acute or chronic pancreatitis.
MAIN OBSERVATIONS
We report the case of a pancreatic panniculitis associated with acute pancreatitis in a 63-year-old man. He presented with a 2-day history of multiple tender subcutaneous nodules, followed by nausea, vomiting, severe epigastric pain and loss of appetite, hours before admission. Laboratory and radiologic findings revealed acute pancreatitis. Histopathological examination from a skin biopsy specimen taken from a nodule showed a mostly lobular panniculitis with "ghost cells", without vasculitis. Nodules disappeared with the resolution of acute pancreatic inflammation, as amylase and lipase levels returned to normal.
CONCLUSIONS
Panniculitis may be the first manifestation of pancreatic disease. Therefore clinicians must have a high index of suspicion for the diagnosis of pancreatic panniculitis.
背景
胰腺性脂膜炎是胰腺疾病的一种罕见并发症，在所有患者中发生率为2%至3%，最常见于急性或慢性胰腺炎患者。
主要观察结果
我们报告了一例63岁男性与急性胰腺炎相关的胰腺性脂膜炎病例。入院前数小时，他出现了2天的多个压痛性皮下结节病史，随后出现恶心、呕吐、严重上腹痛和食欲不振。实验室和影像学检查结果显示为急性胰腺炎。从结节处获取的皮肤活检标本的组织病理学检查显示，主要为小叶性脂膜炎伴“鬼影细胞”，无血管炎。随着淀粉酶和脂肪酶水平恢复正常，急性胰腺炎症消退，结节也随之消失。
结论
脂膜炎可能是胰腺疾病的首发表现。因此，临床医生对胰腺性脂膜炎的诊断必须有高度的怀疑指数。
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