肠系膜脂膜炎是成人自身免疫性糖尿病的一个迹象吗？
IS MESENTERIC PANNICULITIS A SIGN FOR AUTOIMMUNE DIABETES IN ADULTS?
作者信息
Rizos Evangelos C, Panagiotopoulou Thalia, Liberopoulos Evangelos, Elisaf Moses, Tsili Athina, Argyropoulou Maria I, Tigas Stelios K
出版信息
AACE Clin Case Rep. 2019 Apr 25;5(3):e181-e183. doi: 10.4158/ACCR-2018-0239. eCollection 2019 May-Jun.
OBJECTIVE
Mesenteric panniculitis (MP) and sclerosing mesenteritis is an umbrella term used to describe a rare, chronic, and frequently benign fibrosing inflammatory disease that affects the adipose tissue of the mesentery. The diagnosis is usually based on imaging (computed tomography [CT] or magnetic resonance imaging) findings and is confirmed by biopsy. We report the unusual case of a patient with MP with typical CT findings and diabetes mellitus (DM).
METHODS
A 48-year-old male presented for symptomatic new onset DM. An abdominal CT scan revealed a well-defined mesenteric mass compatible with MP. The combination of insulin degludec and sitagliptin/metformin resulted in a decrease of HbA1c; however, this was followed by a subsequent gradual increase in HbA1c and positive glutamic acid decarboxylase auto-antibodies.
RESULTS
The patient developed auto-immune DM that was confirmed by the presence of auto-antibodies.
CONCLUSION
Panniculitis has been infrequently reported in patients with type 2 DM. This is the first report of a patient with MP correlated with auto-immune DM. The possible pathophysiologic mechanisms are discussed.
目的
肠系膜脂膜炎（MP）和硬化性肠系膜炎是一个统称，用于描述一种罕见的、慢性的且通常为良性的纤维化炎症性疾病，该疾病会影响肠系膜的脂肪组织。诊断通常基于影像学（计算机断层扫描[CT]或磁共振成像）结果，并通过活检确诊。我们报告了一例具有典型CT表现且患有糖尿病（DM）的MP患者的罕见病例。
方法
一名48岁男性因有症状的新发糖尿病前来就诊。腹部CT扫描显示一个边界清晰的肠系膜肿块，符合MP表现。德谷胰岛素与西格列汀/二甲双胍联合使用使糖化血红蛋白（HbA1c）降低；然而，随后HbA1c逐渐升高，且谷氨酸脱羧酶自身抗体呈阳性。
结果
该患者出现自身免疫性糖尿病，自身抗体的存在证实了这一点。
结论
2型糖尿病患者中脂膜炎的报道较少。这是第一例与自身免疫性糖尿病相关的MP患者的报告。文中讨论了可能的病理生理机制。
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