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Late pancreatic panniculitis in a simultaneous pancreas kidney transplant patient with failed allografts.
Baig, Mirza M; Yaqub, Muhammad S; Taber, Tim E; Fridell, Jonathan; Sharfuddin, Asif.
Affiliation
  • Baig MM; Department of Medicine-Division of Nephrology/Transplant, Indiana University School of Medicine, Indianapolis, Indiana.
  • Yaqub MS; Department of Medicine-Division of Nephrology/Transplant, Indiana University School of Medicine, Indianapolis, Indiana.
  • Taber TE; Department of Medicine-Division of Nephrology/Transplant, Indiana University School of Medicine, Indianapolis, Indiana.
  • Fridell J; Department of Surgery-Transplant, Indiana University School of Medicine, Indianapolis, Indiana.
  • Sharfuddin A; Department of Medicine-Division of Nephrology/Transplant, Indiana University School of Medicine, Indianapolis, Indiana.
Am J Transplant ; 19(10): 2934-2938, 2019 10.
Article in En | MEDLINE | ID: mdl-31152473
ABSTRACT
We present a rare case of pancreatic panniculitis in a 59-year-old male simultaneous pancreas-kidney (SPK) recipient with failed allografts. The patient presented with fever and painful erythematous nodules on his leg 1 month after stopping all immunosuppression. A thorough infectious and rheumatological workup was negative. He had pancreas rejection 4 years after SKP transplant and was restarted on dialysis after 14 years when his renal allograft failed due to chronic allograft nephropathy. His chronic immunosuppression (tacrolimus, azathioprine) was stopped and prednisone was weaned over 3 months at that time. A skin biopsy revealed saponification of the subcutaneous fat with inflammation pathognomonic of pancreatic panniculitis. Concurrent allograft pancreatitis confirmed with elevated lipase and a computed tomography scan finding of peripancreatic graft stranding and atrophic native pancreas. He was started on pulse steroid therapy for 3 days followed by oral taper. This resulted in dramatic resolution of all skin lesions and normalization of lipase levels within 1 week, followed by resumption of low-dose tacrolimus and azathioprine. This is an extremely rare occurrence of panniculitis in pancreas allograft after 10 years of pancreatic failure associated with stopping immunosuppression.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreatic Diseases / Postoperative Complications / Panniculitis / Kidney Transplantation / Pancreas Transplantation / Graft Rejection Type of study: Diagnostic_studies / Prognostic_studies Limits: Humans / Male / Middle aged Language: En Journal: Am J Transplant Journal subject: TRANSPLANTE Year: 2019 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pancreatic Diseases / Postoperative Complications / Panniculitis / Kidney Transplantation / Pancreas Transplantation / Graft Rejection Type of study: Diagnostic_studies / Prognostic_studies Limits: Humans / Male / Middle aged Language: En Journal: Am J Transplant Journal subject: TRANSPLANTE Year: 2019 Document type: Article