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An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions

Patient: Female, 81 Final Diagnosis: Suspicious of mesenteric panniculitis Symptoms: Dyspnea • edema Medication: — Clinical Procedure: Diuretics Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare disease BACKGROUND: Mesenteric panniculitis (MP) is an idiopathic chronic inflammatory condition...

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Autores principales: Kobayashi, Hiroshi, Notohara, Kenji, Otsuka, Tadashi, Kobayashi, Yuka, Ujita, Masuo, Yoshioka, Yuuki, Suzuki, Naomasa, Aoyagi, Ryuji, Ohashi, Riuko, Suzuki, Toshimitsu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763981/
https://www.ncbi.nlm.nih.gov/pubmed/29298971
http://dx.doi.org/10.12659/AJCR.905744
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author Kobayashi, Hiroshi
Notohara, Kenji
Otsuka, Tadashi
Kobayashi, Yuka
Ujita, Masuo
Yoshioka, Yuuki
Suzuki, Naomasa
Aoyagi, Ryuji
Ohashi, Riuko
Suzuki, Toshimitsu
author_facet Kobayashi, Hiroshi
Notohara, Kenji
Otsuka, Tadashi
Kobayashi, Yuka
Ujita, Masuo
Yoshioka, Yuuki
Suzuki, Naomasa
Aoyagi, Ryuji
Ohashi, Riuko
Suzuki, Toshimitsu
author_sort Kobayashi, Hiroshi
collection PubMed
description Patient: Female, 81 Final Diagnosis: Suspicious of mesenteric panniculitis Symptoms: Dyspnea • edema Medication: — Clinical Procedure: Diuretics Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare disease BACKGROUND: Mesenteric panniculitis (MP) is an idiopathic chronic inflammatory condition of the mesentery. The main symptoms include abdominal pain, abdominal distention, weight loss, fever, nausea, and vomiting. The patients also present with chylous ascites in 14% of the cases and chylous pleural effusion (CPE) in very rare occasions. Despite the previous view of excellent prognosis of MP, two recent papers reported several fatal cases. However, there are still only a few autopsy case reports that describe the macroscopic and histological details of MP cases. CASE REPORT: The patient was an 81-year-old Japanese woman. She complained of edema of her lower legs and face, general fatigue, and dyspnea. She was overweight and had type 2 diabetes (T2D). Computerized tomography (CT) demonstrated massive bilateral pleural effusions, with mild pericardial effusion and mild ascites. There was no pulmonary, cardiac or hepatic condition to explain the effusions. However, MP was suspected based on her CT. She gradually deteriorated into respiratory failure. The autopsy revealed CPEs (left 1,300 mL, right 1,400 mL) and MP in the mesentery of the small intestine. Neither neoplasia nor inflammatory conditions other than MP were detected. CONCLUSIONS: In rare occasions, patients with MP present with CPE or chylothorax. We thought that a possible mechanism of the CPEs was a diaphragmatic defect. We suspected that being overweight and T2D had an etiological relationship with MP in our patient’s case. Adipose tissue of the mesentery is the main focus of MP. We believed that MP would be the best umbrella term of the many synonyms.
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spelling pubmed-57639812018-01-17 An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions Kobayashi, Hiroshi Notohara, Kenji Otsuka, Tadashi Kobayashi, Yuka Ujita, Masuo Yoshioka, Yuuki Suzuki, Naomasa Aoyagi, Ryuji Ohashi, Riuko Suzuki, Toshimitsu Am J Case Rep Articles Patient: Female, 81 Final Diagnosis: Suspicious of mesenteric panniculitis Symptoms: Dyspnea • edema Medication: — Clinical Procedure: Diuretics Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare disease BACKGROUND: Mesenteric panniculitis (MP) is an idiopathic chronic inflammatory condition of the mesentery. The main symptoms include abdominal pain, abdominal distention, weight loss, fever, nausea, and vomiting. The patients also present with chylous ascites in 14% of the cases and chylous pleural effusion (CPE) in very rare occasions. Despite the previous view of excellent prognosis of MP, two recent papers reported several fatal cases. However, there are still only a few autopsy case reports that describe the macroscopic and histological details of MP cases. CASE REPORT: The patient was an 81-year-old Japanese woman. She complained of edema of her lower legs and face, general fatigue, and dyspnea. She was overweight and had type 2 diabetes (T2D). Computerized tomography (CT) demonstrated massive bilateral pleural effusions, with mild pericardial effusion and mild ascites. There was no pulmonary, cardiac or hepatic condition to explain the effusions. However, MP was suspected based on her CT. She gradually deteriorated into respiratory failure. The autopsy revealed CPEs (left 1,300 mL, right 1,400 mL) and MP in the mesentery of the small intestine. Neither neoplasia nor inflammatory conditions other than MP were detected. CONCLUSIONS: In rare occasions, patients with MP present with CPE or chylothorax. We thought that a possible mechanism of the CPEs was a diaphragmatic defect. We suspected that being overweight and T2D had an etiological relationship with MP in our patient’s case. Adipose tissue of the mesentery is the main focus of MP. We believed that MP would be the best umbrella term of the many synonyms. International Scientific Literature, Inc. 2018-01-04 /pmc/articles/PMC5763981/ /pubmed/29298971 http://dx.doi.org/10.12659/AJCR.905744 Text en © Am J Case Rep, 2018 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Kobayashi, Hiroshi
Notohara, Kenji
Otsuka, Tadashi
Kobayashi, Yuka
Ujita, Masuo
Yoshioka, Yuuki
Suzuki, Naomasa
Aoyagi, Ryuji
Ohashi, Riuko
Suzuki, Toshimitsu
An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions
title An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions
title_full An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions
title_fullStr An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions
title_full_unstemmed An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions
title_short An Autopsy Case of Mesenteric Panniculitis with Massive Pleural Effusions
title_sort autopsy case of mesenteric panniculitis with massive pleural effusions
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763981/
https://www.ncbi.nlm.nih.gov/pubmed/29298971
http://dx.doi.org/10.12659/AJCR.905744
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