A case of cytophagic histiocytic panniculitis associated with exertional rhabdomyolysis.

Abstract:

:An 18-year-old man who suffered from panniculitis involving the entire left lower limb after exertional rhabdomyolysis is reported. A high fever (>39 degrees C) and leukocytosis (>20,000/microL) persisted for 1 week, and his general status deteriorated rapidly into pre-disseminated intravascular coagulation, complicated by pleural effusion and prolonged clotting time. His condition was dramatically improved by steroid pulse therapy and he has remained in good health for the 20 months since discharge. Histologic examination of subcutaneous tissue from the swollen left lower limb revealed pleomorphic small, medium or large lymphocytes, macrophages and neutrophils infiltrating the edematous subcutaneous adipose tissue in a lobular panniculitis-like pattern. The majority of inflammatory cells were T lymphocytes, with equal proportions of CD4+ and CD8+ cells. As polymerase chain reaction did not show bands suggesting T cell receptor gamma gene rearrangement, the proliferation of T lymphocytes was considered to be polyclonal. The T lymphocytes also expressed Fas ligand, suggesting the involvement of Fas-mediated cytotoxicity. This case may represent a new category of cytophagic histiocytic panniculitis induced by exertional rhabdomyolysis.

journal_name

Pathol Int

journal_title

Pathology international

authors

Kanai Y,Iwaya K,Kuroda M,Harada M,Hirata F,Mukai K

doi

10.1046/j.1440-1827.2000.01127.x

subject

Has Abstract

pub_date

2000-10-01 00:00:00

pages

858-62

issue

10

eissn

1320-5463

issn

1440-1827

pii

pin1127

journal_volume

50

pub_type

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