Is Mesenteric Panniculitis a Sign for Autoimmune Diabetes in Adults?

ABSTRACT: 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 &a...

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Main Authors: Evangelos C. Rizos, MD, PhD, Thalia Panagiotopoulou, MD, Evangelos Liberopoulos, MD, PhD, Moses Elisaf, MD, PhD, Athina Tsili, MD, PhD, Maria I. Argyropoulou, MD, PhD, Stelios K. Tigas, MD, PhD
Format: Article
Language:English
Published: Elsevier 2019-05-01
Series:AACE Clinical Case Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2376060520303941
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Summary:ABSTRACT: 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.Abbreviations: CT computed tomography DM diabetes mellitus HbA1c hemoglobin A1c MP mesenteric panniculitis SM sclerosing mesenteritis
ISSN:2376-0605