rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2021-471-477rsp-3066Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONSЛобулярный панникулит как проявление панкреатита. Трудности диагностикиLobular panniculitis as a manifestation of pancreatitis. Difficulties in diagnosishttps://orcid.org/0000-0002-4846-5531ЕгороваО. Н.EgorovaO. N.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

onegorova@yandex.ruhttps://orcid.org/0000-0003-3348-5596МасловскийА. Л.MaslovskyA. L.

357538, Российская Федерация, Пятигорск, ул. Адмиральского, 6

357538, Russian Federation, Pyatigorsk, Admiralskogo str., 6

https://orcid.org/0000-0002-7948-6167ЗеленовИ. А.ZelenovI. A.

357538, Российская Федерация, Пятигорск, ул. Адмиральского, 6

357538, Russian Federation, Pyatigorsk, Admiralskogo str., 6

https://orcid.org/0000-0003-4638-9376ГорячевА. H.GoryachevA. N.

357538, Российская Федерация, Пятигорск, ул. Адмиральского, 6

357538, Russian Federation, Pyatigorsk, Admiralskogo str., 6

https://orcid.org/0000-0001-7091-2054БеловБ. С.BelovB. S.

115522, Российская Федерация, Москва, Каширское шоссе, 34а

115522, Russian Federation, Moscow, Kashirskoye Highway, 34A

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationГБУЗ СК «Пятигорская городская клиническая больница № 2»РоссияPyatigorsk City Clinical Hospital N 2Russian Federation202105092021594471477Copyright © Егорова О.Н., Масловский А.Л., Зеленов И.А., Горячев А.H., Белов Б.С., 20212021Егорова О.Н., Масловский А.Л., Зеленов И.А., Горячев А.H., Белов Б.С.Egorova O.N., Maslovsky A.L., Zelenov I.A., Goryachev A.N., Belov B.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3066

Клиническая картина лобулярного панникулита, ассоциированного с поражением поджелудочной железы, может широко варьировать, сопровождаясь поражением суставов и внутренних органов, что затрудняет диагностику заболевания. Приведено клиническое наблюдение торпидного течения панникулита с тотальным поражением органов и систем, наглядно иллюстрирующее возникающие в реальной терапевтической практике трудности дифференциальной диагностики и терапии.

The clinical picture of lobular panniculitis associated with damage to the pancreas can vary widely, accompanied by damage to the joints and internal organs, which complicates the diagnosis of the disease. A clinical observation of a torpid course of lobular panniculitis with total damage to organs and systems is presented, which clearly illustrates the difficulties of differential diagnosis and therapy that arise in real therapeutic practice.

лобулярный панникулитпанкреатический панникулитдиагностикаклинический случайlobular panniculitispancreatic panniculitisdiagnosisclinical caseReferencesRequena L, Yus ES. Panniculitis. Part I. Mostly septal panniculitis. J Am Acad Dermatol. 2001;45(2):163-183. doi: 10.1067/mjd.2001.114736Requena L, Yus ES. Panniculitis. Part I. Mostly septal panniculitis. J Am Acad Dermatol. 2001;45(2):163-183. doi: 10.1067/mjd.2001.114736Requena L, Yus ES. Panniculitis. Part II. Mostly lobular panniculitis. J Am Acad Dermatol. 2001;45(3):325-361. doi: 10.1067/mjd.2001.114735Requena L, Yus ES. Panniculitis. Part II. Mostly lobular panniculitis. J Am Acad Dermatol. 2001;45(3):325-361. doi: 10.1067/mjd.2001.114735Wick MR. Panniculitis: А summary. Semin Diagn Pathol. 2017;34(3):261-272. doi: 10.1053/j.semdp.2016.12.004Wick MR. Panniculitis: А summary. Semin Diagn Pathol. 2017;34(3):261-272. doi: 10.1053/j.semdp.2016.12.004Вербенко ЕВ (ред.). Клиника, дифференциальная диагностика и лечение спонтанного панникулита: методические рекомендации для врачей. М.;1975:18-36.Verbenko EV (ed.). Clinic, differential diagnosis and treatment of spontaneous panniculitis: guidelines for physicians. Moscow;1975:18-36 (In Russ.).Егорова ОН, Белов БC, Глухова СИ, Раденска-Лоповок СГ Идиопатический лобулярный панникулит, как общеклиническая проблема. Терапевтический архив. 2019;91(5):49-53.Egorova ON, Belov BS, Glukhova SI, Radenska-Lopovok SG Idiopathic lobular panniculitis as a general clinical problem. Terapevticheskii arkhiv. 2019;91(5):49-53 (In Russ.). doi: 10.26442/00403660.2019.05.000187Hansen CB, Callen JP. Connective tissue panniculitis: Lupus panniculitis, dermatomyositis, morphea/scleroderma. Dermatol Ther. 2010;23(4):341-349. doi: 10.1111/j.1529-8019.2010.01334.xHansen CB, Callen JP. Connective tissue panniculitis: Lupus panniculitis, dermatomyositis, morphea/scleroderma. Dermatol Ther. 2010;23(4):341-349. doi: 10.1111/j.1529-8019.2010.01334.xTibana TK, Santos RFT, Camilo DMR, Marchiori E, Nunes TF. Mesenteric panniculitis in a patient with rheumatoid arthritis. Radiol Bras. 2019;52(4):277-278. doi: 10.1590/0100-3984.2017.0209Tibana TK, Santos RFT, Camilo DMR, Marchiori E, Nunes TF. Mesenteric panniculitis in a patient with rheumatoid arthritis. Radiol Bras. 2019;52(4):277-278. doi: 10.1590/0100-3984.2017.0209Jo S, Song S. Pancreatitis, panniculitis, and polyarthritis syndrome caused by pancreatic pseudocyst: A case report. World J Clin Cases. 2019;7(18):2808-2814. doi: 10.12998/wjcc.v7.i18.2808Jo S, Song S. Pancreatitis, panniculitis, and polyarthritis syndrome caused by pancreatic pseudocyst: A case report. World J Clin Cases. 2019;7(18):2808-2814. doi: 10.12998/wjcc.v7.i18.2808Ferri V, Ielpo B, Duran H, Diaz E, Fabra I, Caruso R, et al. Pancreatic disease, panniculitis, polyarthrtitis syndrome successfully treated with total pancreatectomy: Case report and literature review. Int J Surg Case Rep. 2016;28:223-226. doi: 10.1016/j.ijscr.2016.09.019Ferri V, Ielpo B, Duran H, Diaz E, Fabra I, Caruso R, et al. Pancreatic disease, panniculitis, polyarthrtitis syndrome successfully treated with total pancreatectomy: Case report and literature review. Int J Surg Case Rep. 2016;28:223-226. doi: 10.1016/j.ijscr.2016.09.019Jiang QW, Wang FD, Wang WZ, Wu X, Shu HJ, Li JN, et al. An analysis of clinical characteristics of twelve cases of mesenteric panniculitis. Zhonghua Nei Ke Za Zhi. 2017;56(2):112-115. doi: 10.3760/cma.j.issn.0578-1426.2017.02.006Jiang QW, Wang FD, Wang WZ, Wu X, Shu HJ, Li JN, et al. An analysis of clinical characteristics of twelve cases of mesenteric panniculitis. Zhonghua Nei Ke Za Zhi. 2017;56(2):112-115. doi: 10.3760/cma.j.issn.0578-1426.2017.02.006Meyyur Aravamudan V, Khan SR, Natarajan SK, Hussain I. The complex relationship between mesenteric panniculitis and malignancy – A holistic approach is still needed to understand the diagnostic uncertainties. Cureus. 2019;11(9):5569. doi: 10.7759/cureus.5569Meyyur Aravamudan V, Khan SR, Natarajan SK, Hussain I. The complex relationship between mesenteric panniculitis and malignancy – A holistic approach is still needed to understand the diagnostic uncertainties. Cureus. 2019;11(9):5569. doi: 10.7759/cureus.5569Badet N, Sailley N, Briquez C, Paquette B, Vuitton L, Delabrousse É. Mesenteric panniculitis: still an ambiguous condition. Diagn Interv Imaging. 2015;96:251-257. doi: 10.1016/j.diii.2014.12.002Badet N, Sailley N, Briquez C, Paquette B, Vuitton L, Delabrousse É. Mesenteric panniculitis: still an ambiguous condition. Diagn Interv Imaging. 2015;96:251-257. doi: 10.1016/j.diii.2014.12.002Graham PM, Altman DA, Gildenberg SR. Panniculitis, pancreatitis, and polyarthritis: A rare clinical syndrome. Cutis. 2018;101:34-37.Graham PM, Altman DA, Gildenberg SR. Panniculitis, pancreatitis, and polyarthritis: A rare clinical syndrome. Cutis. 2018;101:34-37.Francombe J, Kingsnorth AN, Tunn E. Panniculitis, arthritis and pancreatitis. Br J Rheumatol. 1995;34(7):680-683. doi: 10.1093/rheumatology/34.7.680Francombe J, Kingsnorth AN, Tunn E. Panniculitis, arthritis and pancreatitis. Br J Rheumatol. 1995;34(7):680-683. doi: 10.1093/rheumatology/34.7.680Segurado Rodríguez A, Guerra Tapia A, Jaén Olasolo P. Paniculitis pancreática: Estudio de 12 casos y valoración comparativa de sus caracteres epidemiológicos, clínicos, histopatológicos y terapéuticos. Actas Dermosifiliogr. 1999;90:227-234.Segurado Rodríguez A, Guerra Tapia A, Jaén Olasolo P. Paniculitis pancreática: Estudio de 12 casos y valoración comparativa de sus caracteres epidemiológicos, clínicos, histopatológicos y terapéuticos. Actas Dermosifiliogr. 1999;90:227-234.Kim EJ, Park MS, Son HG, Oh WS, Moon KW, Park JM, et al. Pancreatitis, рanniculitis, and рolyarthritis syndrome simulating cellulitis and gouty arthritis. Korean J Gastroenterol. 2019;74(3):175-182. doi: 10.4166/kjg.2019.74.3.175Kim EJ, Park MS, Son HG, Oh WS, Moon KW, Park JM, et al. Pancreatitis, рanniculitis, and рolyarthritis syndrome simulating cellulitis and gouty arthritis. Korean J Gastroenterol. 2019;74(3):175-182. doi: 10.4166/kjg.2019.74.3.175de Frutos Rosa D, Espinosa Taranilla L, González de Canales de Simón P, Vélez Velázquez MD, Guirado Koch C. Pancreatic panniculitis as a presentation symptom of acinar cell carcinoma. Rev Esp Enferm Dig. 2018;110(6):448-450. doi: 10.17235/reed.2018.5203/2017de Frutos Rosa D, Espinosa Taranilla L, González de Canales de Simón P, Vélez Velázquez MD, Guirado Koch C. Pancreatic panniculitis as a presentation symptom of acinar cell carcinoma. Rev Esp Enferm Dig. 2018;110(6):448-450. doi: 10.17235/reed.2018.5203/2017Fernández-Sartorio C, Combalia A, Ferrando J, Alsina M, Iranzo P, Estrach T, et al. Pancreatic panniculitis: A case series from a tertiary university hospital in Spain. Australas J Dermatol. 2018;59:269-272. doi: 10.1111/ajd.12842Fernández-Sartorio C, Combalia A, Ferrando J, Alsina M, Iranzo P, Estrach T, et al. Pancreatic panniculitis: A case series from a tertiary university hospital in Spain. Australas J Dermatol. 2018;59:269-272. doi: 10.1111/ajd.12842Chiari H. Über die sogenannte fettnekrose. Prag. Med. Wochenschr. 1883;8:255-256.Chiari H. Über die sogenannte fettnekrose. Prag. Med. Wochenschr. 1883;8:255-256.Dieker W, Derer J, Henzler T, Schneider A, Rückert F, Wilhelm TJ, et al. Pancreatitis, panniculitis and polyarthritis (PPP-) syndrome caused by post-pancreatitis pseudocyst with mesenteric fistula. Diagnosis and successful surgical treatment. Case report and review of literature. Int J Surg Case Rep. 2017;31:170-175. doi: 10.1016/j.ijscr.2017.01.037Dieker W, Derer J, Henzler T, Schneider A, Rückert F, Wilhelm TJ, et al. Pancreatitis, panniculitis and polyarthritis (PPP-) syndrome caused by post-pancreatitis pseudocyst with mesenteric fistula. Diagnosis and successful surgical treatment. Case report and review of literature. Int J Surg Case Rep. 2017;31:170-175. doi: 10.1016/j.ijscr.2017.01.037Graham PM, Altman DA, Gildenberg SR. Panniculitis, pancreatitis, and polyarthritis: A rare clinical syndrome. Cutis. 2018;101(1):34-37.Graham PM, Altman DA, Gildenberg SR. Panniculitis, pancreatitis, and polyarthritis: A rare clinical syndrome. Cutis. 2018;101(1):34-37.Arbeláez-Cortés A, Vanegas-García AL, Restrepo-Escobar M, Correa-Londoño LA, González-Naranjo LA. Polyarthritis and pancreatic panniculitis associated with pancreatic carcinoma: Review of the literature. J Clin Rheumatol. 2014;20: 433-436. doi: 10.1097/RHU.0000000000000181Arbeláez-Cortés A, Vanegas-García AL, Restrepo-Escobar M, Correa-Londoño LA, González-Naranjo LA. Polyarthritis and pancreatic panniculitis associated with pancreatic carcinoma: Review of the literature. J Clin Rheumatol. 2014;20: 433-436. doi: 10.1097/RHU.0000000000000181Narváez J, Bianchi MM, Santo P, de la Fuente D, Ríos- Rodriguez V, Bolao F, et al. Pancreatitis, panniculitis, and polyarthritis. Semin Arthritis Rheum. 2010;39:417-223. doi: 10.1016/j.semarthrit.2008.10.001Narváez J, Bianchi MM, Santo P, de la Fuente D, Ríos- Rodriguez V, Bolao F, et al. Pancreatitis, panniculitis, and polyarthritis. Semin Arthritis Rheum. 2010;39:417-223. doi: 10.1016/j.semarthrit.2008.10.001Lee S. Pancreatitis, panniculitis, and polyarthritis syndrome simulating cellulitis and gouty arthritis. Korean J Gastroenterol. 2019;74(3):175-182. doi: 10.4166/kjg.2019.74.3.175Lee S. Pancreatitis, panniculitis, and polyarthritis syndrome simulating cellulitis and gouty arthritis. Korean J Gastroenterol. 2019;74(3):175-182. doi: 10.4166/kjg.2019.74.3.175

The authors declare that there are no conflicts of interest present.