AACE Clinical Case Reports (May 2019)

Is Mesenteric Panniculitis a Sign for Autoimmune Diabetes in Adults?

  • 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

Journal volume & issue
Vol. 5, no. 3
pp. e181 – e183

Abstract

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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