Retroperitoneal fibrosis: a retrospective analysis of clinical data on 40 patients
LIU Aiwu1, ZHANG Chunyan2, ZHAO Miansong3
1. Department of Rheumatology and Immunology, Liangxiang Hospital of Capital Medical University, Beijing 102400,China; 2. Department of Radiology and Imaging,3. Department of Rheumatology and Immunology, Beijing Shijitan Hospital of Capital Medical University, Beijing 100038, China
Abstract:Objective To provide more evidence-based medical evidence for the diagnosis and treatment of retroperitoneal fibrosis.Methods The clinical data about forty patients with retroperitoneal fibrosis diagnosed and treated in two clinical centers between 2008 and 2019 was retrospectively analyzed. Such information as demographic characteristics, clinical manifestations, laboratory findings, radiological findings, modalities of treatments with RPF, outcomes of treatment and prognosis of some patients was retrieved from the electronic medical record information systems of the two hospitals. Scheel’s method was used for radiographic classification.Results These patients ranged from 24 to 83 in age, with an average age of 59.13±14.7. Thirty-one of them were males, and the ratio of males to females was 3.5∶1;Twenty-nine of the male patients smoked to different extents but none of the female patients was a smoker. 65% of the patients had such initial symptoms as abdominal pain or back pain or both, followed by leg edema. 5% of the patients without symptoms were spotted by medical examination. Some of the patients had elevated inflammation indexes. In terms of radiographic classification, most of the patients were of Class Ⅰ+Ⅲ, followed by Class I. IgG4 was tested in ten patients and was found to increase in five of these patients, and it was ten times higher than the normal value in one of the patients. The four male patients with higher IgG4 were heavy smokers.Conclusions The cross-sectional studies in the two centers show that most of the patients with retroperitoneal fibrosis are males and advanced in age. CT and MRI scans are the most common and useful tools in the diagnosis of RPF. PET-CT scans are very helpful in diagnosis of retroperitoneal fibrosis. Pathological diagnosis can help clarify the cause of the disease. Management of RPF includes medical therapy and ureteral stenting in the event of severe hydronephrosis. Glucocorticoids are the mainstay RPF treatment.
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