title: Limited systemic sclerosis initially presenting with mesenteric panniculitis.
abstract: Mesenteric panniculitis pertains to a group of uncommon disorders named sclerosing mesenteritis that present with different levels of inflammation and fibrosis of the small bowel mesentery. It is associated with abdominal surgeries, trauma, malignancies, infections and connective tissue diseases. To the best of our knowledge, no cases of sclerosing mesenteritis have been reported in patients with systemic sclerosis. We present a case of a 61-year-old woman who had incidental CT findings of mesenteric panniculitis. Diagnosis was confirmed by biopsy that showed fat necrosis. On further review she had a 1-year history of Raynaud's phenomenon. Physical examination showed sclerodactyly. She had elevated anticentromere antibodies and skin biopsy was consistent with scleroderma. She was diagnosed with limited systemic sclerosis and was treated with D-penicillamine. After 6 years of follow-up, the mesenteric panniculitis and systemic sclerosis both remained stable. This case highlights the importance of considering rheumatic diseases in the differential diagnosis of sclerosing mesenteritis.
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Mariangelí
authors.initials: M
authors.lastname: Arroyo-Ávila
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Vilá
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D005218:Fat Necrosis / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008643:Mesentery / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D015436:Panniculitis, Peritoneal / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D010396:Penicillamine / Q000627:therapeutic use; D011928:Raynaud Disease / Q000150:complications; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D018501:Antirheumatic Agents; D010396:Penicillamine