Mide Adenokarsinomu ile Birlikte Görülen Mezenterik Pannükülit Olgusu
Özet
Yirmi iki yaşında erkek hasta, yoğun fiziksel egzersiz sonrası gelişen halsizlik, karın ağrısı ve iştahsızlık şikayetleri ile başvurdu. İlk başvuruda semptomatik tedavi düzenlenmesine rağmen yakınmaları gerilemeyen hastanın ikinci başvurusunda yapılan tetkiklerde belirgin kreatin kinaz (CK) yüksekliği (36 874 U/L) saptandı ve rabdomiyoliz ön tanısı ile İç Hastalıkları servisine yatırıldı. Erken dönemde başlanan yoğun intravenöz sıvı tedavisi ile CK düzeyleri ve diğer kas enzimlerinde kademeli düşüş izlendi ve hastalık süresince renal komplikasyon gelişmedi. Ayırıcı tanı amacıyla yapılan otoimmün panel, tiroid fonksiyon testleri, viral serolojiler ve elektrolit düzeylerinde patoloji saptanmadı. Klinik bulgular, laboratuvar değerleri ve görüntüleme sonuçları egzersize bağlı rabdomiyoliz tanısını destekledi. Bu olgu, genç erişkinlerde yoğun egzersiz sonrası gelişebilen rabdomiyolizin erken tanı ve etkin sıvı replasmanı ile komplikasyonsuz seyredebileceğini vurgulamaktadır.
Referanslar
Hussein, M.R.A. and S.R. Abdelwahed, Mesenteric panniculitis: an update. Expert Review of Gastroenterology & Hepatology, 2015. 9(1): p. 67-78.
Issa, I. and H. Baydoun, Mesenteric panniculitis: various presentations and treatment regimens. World journal of gastroenterology: WJG, 2009. 15(30): p. 3827.
Daskalogiannaki, M., et al., CT evaluation of mesenteric panniculitis: prevalence and associated diseases. American journal of roentgenology, 2000. 174(2): p. 427-431.
Bush, R., Sclerosing mesenteritis response to cyclophosphamide. Arch Intern Med, 1996. 146: p. 684-688.
Nicholson, J., et al., Mesenteric panniculitis in Merseyside: a case series and a review of the literature. The Annals of The Royal College of Surgeons of England, 2010. 92(6): p. e31-e34.
van Putte-Katier, N., et al., Mesenteric panniculitis: prevalence, clinicoradiological presentation and 5-year follow-up. The British journal of radiology, 2014. 87(1044): p. 20140451.
Emory, T.S., et al., Sclerosing mesenteritis, mesenteric panniculitis and mesenteric lipodystrophy: a single entity? The American journal of surgical pathology, 1997. 21(4): p. 392-398.
Coulier, B., Mesenteric panniculitis part 2: prevalence and natural course: mdct prospective study. Journal of the Belgian Society of Radiology, 2011. 94(5): p. 241-246.
Pinheiro, F., A. Rêgo, and I. Araújo-Filho, Mesenteric panniculitis in the elderly–update on diagnostic and therapeutic approach. Int J Surg Med, 2016. 2(3): p. 127-133.
McLaughlin, P.D., A. Filippone, and M.M. Maher, The “misty mesentery”: mesenteric panniculitis and its mimics. American Journal of Roentgenology, 2013. 200(2): p. W116-W123.
Mindelzun, R.E., et al., The misty mesentery on CT: differential diagnosis. AJR. American journal of roentgenology, 1996. 167(1): p. 61-65.
Buchwald, P., et al., Cohort study of mesenteric panniculitis and its relationship to malignancy. Journal of British Surgery, 2016. 103(12): p. 1727-1730.
Halligan, S., A. Plumb, and S. Taylor, Mesenteric panniculitis: systematic review of cross-sectional imaging findings and risk of subsequent malignancy. European Radiology, 2016. 26(12): p. 4531-4537.
Sung, H., et al., Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 2021. 71(3): p. 209-249.
Lauren, P., The two histological main types of gastric carcinoma: diffuse and so‐called intestinal‐type carcinoma: an attempt at a histo‐clinical classification. Acta pathologica microbiologica Scandinavica, 1965. 64(1): p. 31-49.
Pernot, S., et al., Signet-ring cell carcinoma of the stomach: Impact on prognosis and specific therapeutic challenge. World Journal of Gastroenterology: WJG, 2015. 21(40): p. 11428.
Akram, S., et al., Sclerosing mesenteritis: clinical features, treatment, and outcome in ninety-two patients. Clinical Gastroenterology and Hepatology, 2007. 5(5): p. 589-596.
Gunes, S.O., et al., Association between mesenteric panniculitis and non-neoplastic disorders. Clinical Imaging, 2021. 79: p. 219-224.
Pereira, J.P.T., et al., Sclerosing mesenteritis and disturbance of glucose metabolism: A new relationship? A case series. The American Journal of Case Reports, 2016. 17: p. 55.
Gögebakan, Ö., M.A. Osterhoff, and T. Albrecht. Mesenteric panniculitis (MP): a frequent coincidental CT finding of debatable clinical significance. in RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. 2018. © Georg Thieme Verlag KG.
Coulier, B., Mesenteric panniculitis part 1: mdct-pictorial review. Journal of the Belgian Society of Radiology, 2011. 94(5): p. 229-240.
Protin-Catteau, L., et al., Mesenteric panniculitis: review of consecutive abdominal MDCT examinations with a matched-pair analysis. Acta radiologica, 2016. 57(12): p. 1438-1444.
Yeh, E.T. and C.L. Bickford, Cardiovascular complications of cancer therapy: incidence, pathogenesis, diagnosis, and management. Journal of the American College of Cardiology, 2009. 53(24): p. 2231-2247.
