Unusual course of panniculitis with ascites

Overview

Panniculitis belongs to a heterogeneous group of inflammatory diseases, which affects subcutaneous adipose tissue. Typical clinical feature is represented by tender subcutaneous nodules, often accompanied with systemic symptoms. Organ involvement is rarely present. The authors describe a case report of 27-year-old patient who was evaluated for fever, elevation of acute phase reactants, low-abdomen pain, and small tender subcutaneous nodules. PET/CT examination and subsequent biopsy demonstrated panniculitis. After a transient disease improvement associated with treatment, relapse of fever and large ascites accompanied with elevated liver enzymes and high levels of tumor markers appeared. Extensive battery of tests and imaging examinations revealed neither malignancy nor inflammatory disease as a cause of the ascites. Per exclusion, it was possible to categorize these symptoms into the wide scale of panniculitis manifestations, and to start appropriate treatment.

Key words:
panniculitis, ascites, febrile, vasculitis