Morejón PEL, Martínez FM, Rodríguez HS, Guzmán MDM, Baez SF, Fors LEC

Language: Spanish
References: 7
Page: 407-414
PDF size: 152.86 Kb.

ABSTRACT

Retroperitoneal fibrosis is a rare disease. Its epidemiology is a 1/1 million persons/year, It is more common in men than in women, ocuring in midle age, and its cause is primary or unknown in 75 % of cases. A 43 year-old patient, who had previous health history, referred to his family doctor not to feel well and with back pain associated with abnormalities of the urinary sediment, which was interpreted as urinary tract infection. Treatment started with ciprofloxacin antibiotic with no improvement. This patient was attended at nefrology guard, where emergency supplemental analysis were indicated. Results showed: creatinine values of 1024 micromol/L, high anion gap metabolic acidosis, and hydronephrotic kidney ultrasound. three hemodialysis sessions were indicated. At discussion of complex cases, a retroperitoneal fibrosis diagnosis was assessed, which was confirmed by CT scan at 72 hours of hospital arrival. Methylprednisolone therapy during three days was iniciated, followed by prednisone and cyclophosphamide for two years, with blood chemistry studies, complete blood count, and urine studies in correspondence with treatment response. complete remission of the disease without relapse was achieved.

REFERENCES

1. Castro Iglesias N, Belhassen-García M, Velasco-Tirado V, Carpio-Pérez A, Inés-Revuelta S, Martín-Barba S, et al. Enfermedad de Ormond: experiencia de cinco casos. Reumatol Clin. 2010;6(4):199-202.

2. Orlich C, Gutiérrez J. Fibrosis retroperitoneal. Acta Médica Costarricense. 2005;4(3):151-3.

3. Cristian Muñoz T, Jorge Maira S, Fernando Gómez L, Juan Stambuk M, Raúl Valenzuela P, Martín Etchart C, et al. Fibrosis Retroperitoneal: caso clínico y revisión de la literatura. Gast Latinoamer. 2006;17(1):79-85.

4. Kermani T, Crowson C, Achenbach S, Luthra H. Idiopathic retroperitoneal Fibrosis: A retrospective review of clinical presentation, treatment and outcomes. Mayo Clin Proc. 2011;86(4):297-303.

5. Kamisawa T, Nakajima H, Egawa N, Funata N, Tsuruta K, Okamoto A, et al. IgG4 Related Sclerosing Disease Incorporating Sclerosing Pancreatitis, Cholangitis, Sialadenitis and Retroperitoneal Fibrosis with Limphadenopathy. Pancreatology. 2006;6(1-2):132-7.

6. Alberso R, Schurman J. IgG4 breaking the rules. Inmunology. 2002;105:9-19.

7. Masaki Y, Dong L, Kurose N, Kitagawa K, Morikawa Y, Yamamoto Y, et al. Proposal for a new clinical entity, IgG4 positive multiorgan lymphoprolifertative syndrome: analysis of 64 cases of IgG4-related disorders. Amer Rheum Dis. 2011;68:1310-15.