A man in his forties with a history of alcohol abuse (200 g/day) presented with progressive multiple joint pain. He did not have abdominal, respiratory or urinary complaints. Physical examination revealed bilateral elbow, knee, and ankle joint swelling, and tender erythematous subcutaneous nodules on the trunk and extremities. Laboratory examination showed leukocytosis (36,100/µL; 4000–9000/µL), elevated amylase (7096 U/L; 18–53 U/L), lipase (12,640 U/L; 11–53 U/L), and C-reactive protein (22.4 mg/dl; 0–0.3 mg/dl).
