¿Pancreatitis con infartos óseos y paniculitis: es correcto el síndrome PPP (pancreatitis, paniculitis, poliartritis)? Presentación de 2 casos clínicos y revisión de la literatura

The pancreatitis, panniculitis and polyarthritis syndrome (PPP) is mainly caused by systemic release of pancreatic enzymes to the blood stream that cause inflammation of subcutaneous tissue (primary panniculitis) and periarticular space (arthritis). It is less commonly associated with bone marrow involvement. We showed two patients with PPP syndrome with clinical arthritis, extensive bone infarctions, and contiguous panniculitis. A literature review found very few cases evaluated by magnetic resonance. In our analysed cases the arthritis syndrome was associated with bone infarctions and avascular necrosis. Extensive bone necrosis can produce disruption of cortical bone and secondary panniculitis, making it difficult to distinguish from arthritis.