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Mesenteric panniculitis: diagnostic precision
  1. Domingos Sousa,
  2. Ana Verónica Varela,
  3. Margarida Viana Coelho,
  4. Catarina Jorge
  1. Internal Medicine, Centro Hospitalar Universitário do Algarve, Faro, Portugal
  1. Correspondence to Dr Domingos Sousa, domingos.sousaa{at} and Dr Ana Verónica Varela, anaveronike.varela{at}


A previously healthy 74-year-old woman was admitted with vespertine fever, tremors, shivers and loss of appetite within the previous month. Blood tests revealed an elevated C reactive protein serum level. Serologies for infection were negative. Blood cultures grew no organisms. Colonoscopy revealed normal findings. CT showed typical findings of mesenteric panniculitis with infiltration of mesenteric fat that was circumscribed by hyperattenuating capsule and contained enlarged homogenous lymph nodes. The histopathological analysis from mesenterium revealed non-specific signs of chronic inflammation. On institution of prednisolone, the clinical symptoms subsided, and we replaced it with azathioprine after 1 month. After 12 months of therapy, the patient remained asymptomatic, normalised the serological inflammatory markers and repeat CT revealed normal mesenteric fat.

  • gastrointestinal system
  • medical education
  • medical management
  • radiology
  • general surgery
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  • DS, AVV, MVC and CJ contributed equally.

  • Contributors DS, AVV, MVC and CJ contributed equally to the discussion, interpretation and writing of the present manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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