Pancreatic panniculitis in active systemic lupus erythematosus

Goyal, Amrita; Jain, Meera; Rehberg, Kim; Goodman, Warren H.; Gertner, Elie

doi:10.1111/cup.13493

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…In our patient, renal dysfunction and SLE both could have contributed to the elevated lipase levels. Goyal et al reported a case of SLE with ESRD with pancreatic panniculitis resulting in elevated pancreatic enzymes [15]. Hasselbacher et al reported an increase in the levels of amylase and lipase in SLE patients without any abdominal cause or renal dysfunction [16].…”

Section: Discussionmentioning

confidence: 99%

Hyperlipasemia Sans Pancreatitis: A Case Series

George,

Gnanamoorthy,

Suthakaran

et al. 2023

Cureus

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Acute pancreatitis results in inflammation and autodigestion of pancreatic acinar cells leading to the elevation of pancreatic enzymes, namely, amylase and lipase. Serum lipase levels have long been considered a hallmark of acute pancreatitis. However, pancreatitis is not always the cause of elevated serum lipase levels. This series presents four patients who had elevated serum lipase levels without any demonstrable damage to the pancreas on imaging. On further evaluation, one of the patients was found to have acute on chronic kidney disease (CKD) whose lipase levels settled later. A patient presenting with an episode of acute gastroenteritis, later diagnosed to have Crohn's disease, also had hyperlipasemia, which improved after a course of initial antibiotics. Non-gastrointestinal causes, such as lupus nephritis and organophosphate (OP) poisoning, also had elevated lipase levels on presentation, in which the hyperlipasemia settled with supportive treatments. It is important to remember other causes of elevated lipase levels in patients with a normal pancreas on imaging studies.

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Section: Discussionmentioning

confidence: 99%

Hyperlipasemia Sans Pancreatitis: A Case Series

George,

Gnanamoorthy,

Suthakaran

et al. 2023

Cureus

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“…Blood samples were collected from all patients within 24 h of admission, and serum amylase and lipase activities were measured. The reference value of amylase was 25-125 U/l (13) and the reference value of lipase was 23-300 U/l (14). Abdominal CT scan was used as the standard imaging method and enhanced CT scan was performed on patients with an indefinite diagnosis (Fig.…”

Section: Methodsmentioning

confidence: 99%

Assessment of acute pancreatitis severity via determination of serum levels of hsa‑miR‑126‑5p and IL‑6

et al. 2020

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Early assessment of acute pancreatitis (AP) severity is key to its treatment. The present study aimed to explore the role of microRNAs (miRNAs/miRs) combined with inflammatory factors in determining AP severity. For this, serum pro-inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-1, IL-6, IL-8 and IL-10)] and miRNAs [ Homo sapiens (hsa)-miR-548d-5p, hsa-miR-126-5p and hsa-miR-130b-5p] were detected in patients with mild AP (MAP), severe AP (SAP) and recurrent AP (RAP). High expression of IL-10, TNF-α, hsa-miR-126-5p, hsa-miR-548d-5p and hsa-miR-130b-5p was able to distinguish SAP from MAP and RAP (P<0.05). Multifactorial binary logistic regression analysis indicated that IL-1/IL-6 combined with hsa-miR-126-5p/hsa-miR-548d-5p had a significant influence on AP and AP severity (P<0.05). Receiver operating characteristic analysis revealed that IL-1 combined with hsa-miR-126-5p [area under the curve (AUC), 0.926; sensitivity, 90.0%; specificity, 86.7%, P<0.001] and IL-6 combined with hsa-miR-126-5p (AUC, 0.952; sensitivity, 93.3%; specificity, 90.0%; P<0.001) were able to better distinguish MAP from SAP than IL-1/IL-6 combined with hsa-miR-548d-5p, lipase, and amylase. IL-1 or IL-6 combined with hsa-miR-548d-5p (AUC, 0.924; sensitivity, 83.3%; specificity, 93.3%; P<0.001) were able to better distinguish SAP from RAP than IL-1/IL-6 combined with hsa-miR-126-5p, lipase, and amylase. IL-1 combined with hsa-miR-126-5p (AUC, 0.926; sensitivity, 90.0%; specificity, 86.7%; P<0.001) and IL-6 combined with hsa-miR-126-5p (AUC, 0.952; sensitivity, 93.3%; specificity, 90.0%; P<0.001) were able to better differentiate between MAP and RAP than IL-1/IL-6 combined with hsa-miR-548d-5p, lipase, and amylase. These results demonstrated that the combined detection of serum IL-6 and hsa-miR-126-5p may be useful for the early prediction of AP classification.

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Pancreatic panniculitis associated with periampullary duodenal diverticulum

Tirnanic,

Radevic,

Djordjevic

et al. 2024

VOJNOSANIT PREGL

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Introduction. Pancreatic panniculitis is a rare type of lobular panniculitis that manifests as painful erythematous nodules on the skin of the lower extremities. Subcutaneous fat necrosis caused by the release of pancreatic enzymes is the underlying cause of the disease, affecting around 2 to 3% of patients with pancreatic diseases. Case report. We present a case of a 58-year-old male patient who exhibited painful erythematous nodules on the lower extremities and trunk. Laboratory results revealed increased levels of pancreatic enzymes, amylase, and lipase, as well as heightened levels of glucose and inflammation markers. The histological analysis of the skin lesion biopsy revealed the presence of predominantly lobular panniculitis in the hypodermis, areas of fatty tissue necrosis/saponification, and remnants of adipocytes (??ghost cells??). Abdominal CT scan demonstrated periampullary diverticulum of the duodenum, with no signs of pancreatitis or other pancreatic abnormalities. Esophagogastroduodenoscopy showed a wide opening of the periampullary diverticulum in the D2 segment of the duodenum. The patient was successfully treated with pancreatin therapy, resulting in a significant reduction of skin lesions and decreased levels of pancreatic enzymes. Conclusion. Pancreatic panniculitis can be caused by periampullary duodenal diverticula that exert pressure on the pancreatic duct, leading to elevated levels of pancreatic enzymes. Symptomatic duodenal diverticula may be treated with operative or non-operative measures, depending on the individual characteristics of the patient. Treatment of pancreatic panniculitis primarily involves addressing any underlying medical condition.

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Pancreatic panniculitis in active systemic lupus erythematosus

Cited by 4 publications

References 12 publications

Hyperlipasemia Sans Pancreatitis: A Case Series

Hyperlipasemia Sans Pancreatitis: A Case Series

Assessment of acute pancreatitis severity via determination of serum levels of hsa‑miR‑126‑5p and IL‑6

Pancreatic panniculitis associated with periampullary duodenal diverticulum

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