Coffee colored pleural fluid-abdominal cyst-erythema nodosum / 中华风湿病学杂志

ABSTRACT

Objective To discuss the diagnosis and treatment of systemic lupus erythematosus(SLE)patients associated with pancreatic pleural effusion and pancreaticpanniculitis.Methods Retrospectively analyzed the clinical data,therapy and experiences.Results A 40-year-old female SLE patient associated with pancreatitis,huge pancreatic pseudocysts,pancreatic pleural effusion,pancreatic panniculitis.Abdominal computed tomography(CT)showed an edematous swelling of the pancreas and several pseudocysts,the biggest one measuring 230 mm×95 am.Markedly elevated amylase (11 327 U/L)was contained in the massive pleural effusion.Erythema nodosum tissue pathology revealed the pancreatic panniculitis.The pscudocyst did not completely resolve with high-dose steroid.Growth hormone release inhibiting hormone (GIH),ulinastatin,nasojejunal feeding,and it was later complicated by infection and rupture.After a surgical percutaneous drainage for the complicated pseudocyst,the clinical symptoms and signs were markedly improved.Conclusion This case shows the importance of performing eady drainage rather than conservative treatment for pancreatic pseudocyst in patients with lupus-associated pancreatitis.