A case of pancreatic panniculitis

We report a case of pancreatic panniculitis associated with acute pancreatitis. The patient was a 63-year-old woman who presented with multiple painful erythematous nodules on both shins and had a mild fever and chill. Histopathologic findings showed fat necrosis with anucleate "ghost- like" fat cells with a thick shadowy wall. Laboratory evaluation revealed an increase in serum blood amylase and lipase. We diagnosed as pancreatic panniculitis associated with acute pancreatitis. Past medical history included rheumatoid arthritis and chronic renal failure treated with hemodialysis. She was taking several medicines due to rheumatoid arthritis and was newly prescribed the mizoribine (Bredinin®), 50 mg twice daily for 50 days. We therefore considered the possibility of drug induced pancreatitis due to mizoribine.