1
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Kunow A, Freyer Martins Pereira J, Chenot JF. Extravertebral low back pain: a scoping review. BMC Musculoskelet Disord 2024; 25:363. [PMID: 38714994 PMCID: PMC11075250 DOI: 10.1186/s12891-024-07435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Low back pain (LBP) is one of the most common reasons for consultation in general practice. Currently, LBP is categorised into specific and non-specific causes. However, extravertebral causes, such as abdominal aortic aneurysm or pancreatitis, are not being considered. METHODS A systematic literature search was performed across MEDLINE, Embase, and the Cochrane library, complemented by a handsearch. Studies conducted between 1 January 2001 and 31 December 2020, where LBP was the main symptom, were included. RESULTS The literature search identified 6040 studies, from which duplicates were removed, leaving 4105 studies for title and abstract screening. Subsequently, 265 publications were selected for inclusion, with an additional 197 publications identified through the handsearch. The majority of the studies were case reports and case series, predominantly originating from specialised care settings. A clear distinction between vertebral or rare causes of LBP was not always possible. A range of diseases were identified as potential extravertebral causes of LBP, encompassing gynaecological, urological, vascular, systemic, and gastrointestinal diseases. Notably, guidelines exhibited inconsistencies in addressing extravertebral causes. DISCUSSION Prior to this review, there has been no systematic investigation into extravertebral causes of LBP. Although these causes are rare, the absence of robust and reliable epidemiological data hinders a comprehensive understanding, as well as the lack of standardised protocols, which contributes to a lack of accurate description of indicative symptoms. While there are certain disease-specific characteristics, such as non-mechanical or cyclical LBP, and atypical accompanying symptoms like fever, abdominal pain, or leg swelling, that may suggest extravertebral causes, it is important to recognise that these features are not universally present in every patient. CONCLUSION The differential diagnosis of extravertebral LBP is extensive with relatively low prevalence rates dependent on the clinical setting. Clinicians should maintain a high index of suspicion for extravertebral aetiologies, especially in patients presenting with atypical accompanying symptoms.
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Affiliation(s)
- Anna Kunow
- Department of General Practice, University Medicine Greifswald, 17475, Fleischmannstraße, Greifswald, Germany.
| | | | - Jean-François Chenot
- Department of General Practice, University Medicine Greifswald, 17475, Fleischmannstraße, Greifswald, Germany
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2
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Liu L, Yan H, Wang Y, Xie Y, Jiang L, Zhao J, Gao C, Li X, Wang C. Decreased absolute number of peripheral regulatory T cells in patients with idiopathic retroperitoneal fibrosis. Front Immunol 2022; 13:1012513. [PMID: 36524110 PMCID: PMC9744965 DOI: 10.3389/fimmu.2022.1012513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
Objective In order to determine whether the immune balance of T helper 17(Th17)/regulatory T(Treg) is related to the pathogenesis of idiopathic retroperitoneal fibrosis (IRPF), we analyzed the differences in peripheral blood lymphocytes, CD4+T cell subsets and cytokines between patients with IRPF and healthy people to clarify the CD4+T cell subsets, especially Treg cell subsets, and the role of cytokines in the pathogenesis of IRPF. Methods This study included 22 patients with IRPF, 36 patients with IgG4-related diseases (IgG4-RD) without retroperitoneal fibrosis (RPF), and 28 healthy controls. The absolute numbers and percentage of peripheral blood lymphocyte subsets and CD4+T cell subsets in each group were detected by flow cytometry, and the serum cytokine level was detected by flow cytometric bead array (CBA). Results Compared with the healthy group, the absolute value of B cells in peripheral blood of IRPF patients was significantly decreased, and T, natural killer (NK), CD4+ and CD8+ were not significantly abnormal. The absolute numbers of Th2 cells were lower than healthy group(p=0.043). In particular, the absolute numbers of Treg cells were significantly lower than healthy group(p<0.001), while the absolute numbers of Th17 cells increased(p=0.682). Th17/Treg was significantly higher than healthy group (p< 0.001). Cytokine analysis showed that the level of interleukin (IL)-4 in IRPF patients was higher than healthy group(p=0.011), IL-6, IL-10, IL-17, TNF-α and IFN-γ were significantly higher than healthy group (all p<0.001). Receiver operating characteristic (ROC) curves showed that IL-10 and TNF-α could distinguish bilateral ureteral dilatation in IRPF patients, with areas under the ROC curve (AUCs) of 0.813 (95% CI:0.607-1.000, p=0.026) and 0.950 (95% CI:0.856-1.000, p=0.001), respectively. IL-6 could distinguish bilateral ureteral obstruction, with an AUC of 0.861 (95% CI: 0.682-1.000, p=0.015). Conclusions Our study showed that IRPF patients had reduced Treg cells and indeed had Th17/Treg imbalance, which may be related to the pathogenesis of the disease. The levels of IL-6, IL-10 and TNF-α appear to be associated with the progression of IRPF.
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Affiliation(s)
- Lu Liu
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China,Shanxi Key Laboratory of Immunomicroecology, Taiyuan, Shanxi, China
| | - Huanhuan Yan
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China,Shanxi Key Laboratory of Immunomicroecology, Taiyuan, Shanxi, China
| | - Yanyan Wang
- Department of Rheumatology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, Shanxi, China
| | - Yuhuan Xie
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China,Shanxi Key Laboratory of Immunomicroecology, Taiyuan, Shanxi, China
| | - Lei Jiang
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China,Shanxi Key Laboratory of Immunomicroecology, Taiyuan, Shanxi, China
| | - Jinfang Zhao
- Department of Medical Statistics, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chong Gao
- Pathology, Joint Program in Transfusion Medicine, Brigham and Women’s Hospital/Children’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Xiaofeng Li
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China,Shanxi Key Laboratory of Immunomicroecology, Taiyuan, Shanxi, China
| | - Caihong Wang
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China,Shanxi Key Laboratory of Immunomicroecology, Taiyuan, Shanxi, China,*Correspondence: Caihong Wang,
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3
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Chen AT, Shi YQ, Tan B, Zhu L, Luo YP, Zhong W, Wang MZ, Xu Y. Case Report: A Programmed Cell Death-1 Inhibitor-Related Abdominal Fibroinflammatory Reaction Affecting Multiple Organs in A Non-Small-Cell Lung Cancer Patient. Front Immunol 2022; 13:874932. [PMID: 35860268 PMCID: PMC9292327 DOI: 10.3389/fimmu.2022.874932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/06/2022] [Indexed: 12/12/2022] Open
Abstract
Immunotherapy utilizing programmed cell death-1 (PD-1)/PD-L1 inhibitors has been regarded as a rising hope for tumor patients, and their effects have been demonstrated in many clinical trials. However, immune-related adverse events also occur in patients and can sometimes have severe consequences. Pembrolizumab (Keytruda) is a humanized monoclonal anti-PD-1 antibody that has been approved by the US Food and Drug Administration for non-small-cell lung cancer. Here, we report a rare case of an abdominal fibroinflammatory reaction that affected multiple organs during anti-PD-1 immunotherapy using pembrolizumab in a non-small-cell lung cancer patient. The patient’s case demonstrates that immunotherapy-related abdominal fibroinflammatory reactions need to be considered, especially for patients with a history of pre-existing conditions in the abdomen. Glucocorticoids may be useful as a treatment when a diagnosis is confirmed.
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Affiliation(s)
- An-Tian Chen
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Quan Shi
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bei Tan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Liang Zhu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ya-Ping Luo
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Wei Zhong
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meng-Zhao Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Xu
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Yan Xu,
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4
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Awonuga AO, Chatzicharalampous C, Thakur M, Rambhatla A, Qadri F, Awonuga M, Saed G, Diamond MP. Genetic and Epidemiological Similarities, and Differences Between Postoperative Intraperitoneal Adhesion Development and Other Benign Fibro-proliferative Disorders. Reprod Sci 2021; 29:3055-3077. [PMID: 34515982 DOI: 10.1007/s43032-021-00726-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 08/22/2021] [Indexed: 12/11/2022]
Abstract
Intraperitoneal adhesions complicate over half of abdominal-pelvic surgeries with immediate, short, and long-term sequelae of major healthcare concern. The pathogenesis of adhesion development is similar to the pathogenesis of wound healing in all tissues, which if unchecked result in production of fibrotic conditions. Given the similarities, we explore the published literature to highlight the similarities in the pathogenesis of intra-abdominal adhesion development (IPAD) and other fibrotic diseases such as keloids, endometriosis, uterine fibroids, bronchopulmonary dysplasia, and pulmonary, intraperitoneal, and retroperitoneal fibrosis. Following a literature search using PubMed database for all relevant English language articles up to November 2020, we reviewed relevant articles addressing the genetic and epidemiological similarities and differences in the pathogenesis and pathobiology of fibrotic diseases. We found genetic and epidemiological similarities and differences between the pathobiology of postoperative IPAD and other diseases that involve altered fibroblast-derived cells. We also found several genes and single nucleotide polymorphisms that are up- or downregulated and whose products directly or indirectly increase the propensity for postoperative adhesion development and other fibrotic diseases. An understanding of the similarities in pathophysiology of adhesion development and other fibrotic diseases contributes to a greater understanding of IPAD and these disease processes. At a very fundamental level, blocking changes in the expression or function of genes necessary for the transformation of normal to altered fibroblasts may curtail adhesion formation and other fibrotic disease since this is a prerequisite for their development. Similarly, applying measures to induce apoptosis of altered fibroblast may do the same; however, apoptosis should be at a desired level to simultaneously ameliorate development of fibrotic diseases while allowing for normal healing. Scientists may use such information to develop pharmacologic interventions for those most at risk for developing these fibrotic conditions.
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Affiliation(s)
- Awoniyi O Awonuga
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
| | - Charalampos Chatzicharalampous
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Mili Thakur
- Reproductive Genomics Program, The Fertility Center, Grand Rapids, MI, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Anupama Rambhatla
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Farnoosh Qadri
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Modupe Awonuga
- Division of Neonatology, Department of Pediatrics and Human Development, Michigan State University, 1355 Bogue Street, East Lansing, MI, USA
| | - Ghassan Saed
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Michael P Diamond
- Department of Obstetrics and Gynecology, Augusta University, 1120 15th Street, CJ-1036, Augusta, GA, 30912, USA
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5
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Venkatachalapathy VSS, Palathullil DG, Sam DM, Abraham GP. Surgical management in retroperitoneal fibrosis: beyond ureterolysis. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00218-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Retroperitoneal fibrosis can be associated with bilateral dense and extensive periureteral adhesions. When ureterolysis could not be successfully performed due to disease extent and severity, elaborate ureteral reconstructive procedures will be required.
Case presentation
A young male with retroperitoneal fibrosis presented with bilateral hydroureteronephrosis. The ureteral involvement was extensive and adhesions were dense. He was managed by laparoscopic boari flap ureteroneocystostomy on one renal unit and laparoscopic nephrectomy with renal autotransplantation on the other renal unit.
Conclusions
Ureterolysis is not feasible in all cases of retroperitoneal fibrosis. Extensive bilateral ureteral reconstruction without using intestinal segments is feasible. Minimally invasive surgical reconstructive procedures can be successfully employed in such scenarios also.
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6
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Liedtke KR, Käding C, Döring P, Bekeschus S, Glitsch AS. A case of giant retroperitoneal lymphangioma and IgG4-positive fibrosis: Causality or coincidence? SAGE Open Med Case Rep 2021; 9:2050313X211016993. [PMID: 34094565 PMCID: PMC8141978 DOI: 10.1177/2050313x211016993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/21/2021] [Indexed: 11/17/2022] Open
Abstract
Several chronic inflammatory diseases have been found to be a subtype of IgG4-related disease, all of which have a typical clinical and histological change, which is based in particular on an overexpression of IgG4 and subsequent fibrosis. At least a part of the retroperitoneal fibrosis, which was originally classified as idiopathic, seems to be assigned to IgG4-related disease. Lymphangiomas are benign, cystic tumors that rarely occur in adults. However, there is no firm association with IgG4-related disease described in the literature to date. This report is about a patient suffering from acute renal failure due to a giant retroperitoneal cyst. Surgical resection remains incomplete in the iliac vessel area due to severe fibrosis and histology revealed features of both lymphangioma and IgG4+ fibrosis. The case description is followed by a brief overview of IgG4-related disease and a consideration of whether lymphangiomas might be assigned to this topic.
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Affiliation(s)
- Kim Rouven Liedtke
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany.,Department of Trauma and Orthopedic Surgery, Experimental Trauma Surgery, University Medical Center Schleswig-Holstein
| | - Christoph Käding
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany.,Department of Urology, Greifswald University Medical Centre, Greifswald, Germany
| | - Paula Döring
- Institute of Pathology, Greifswald University Medical Centre, Greifswald, Germany
| | - Sander Bekeschus
- Centre for Innovation Competence (ZIK) plasmatis, Leibniz Institute for Plasma Science and Technology (INP Greifswald), Greifswald, Germany
| | - Anne Susann Glitsch
- Department of General, Visceral, Thoracic and Vascular Surgery, Greifswald University Medical Centre, Greifswald, Germany
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7
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Kromer C, Winfield H, Franklin M. Cutaneous involvement in a case of multifocal idiopathic fibrosclerosis. JAAD Case Rep 2020; 6:357-358. [PMID: 32258321 PMCID: PMC7103662 DOI: 10.1016/j.jdcr.2020.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Harry Winfield
- Department of Dermatology, MetroHealth Medical Center, Cleveland, Ohio.,Department of Pathology, MetroHealth Medical Center, Cleveland, Ohio
| | - Matthew Franklin
- Department of Dermatology, MetroHealth Medical Center, Cleveland, Ohio
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8
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El Bèze N, Blacher J, Martin A, Emmerich J. Aortic atherosclerosis complicated by retroperitoneal fibrosis treated only by optimal cardiovascular risk factors management. JOURNAL DE MEDECINE VASCULAIRE 2020; 45:41-43. [PMID: 32057325 DOI: 10.1016/j.jdmv.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 09/29/2019] [Indexed: 06/10/2023]
Affiliation(s)
- N El Bèze
- Unité Hypertension Artérielle, Prévention et Thérapeutique Cardiovasculaires, Hôtel-Dieu, AP-HP et Université Paris-Descartes, 1 Parvis Notre-Dame - Pl. Jean-Paul II, 75004 Paris, France.
| | - J Blacher
- Unité Hypertension Artérielle, Prévention et Thérapeutique Cardiovasculaires, Hôtel-Dieu, AP-HP et Université Paris-Descartes, 1 Parvis Notre-Dame - Pl. Jean-Paul II, 75004 Paris, France
| | - A Martin
- Université de Médecine Johns Hopkins, 3400N. Charles Street, Baltimore, MD 21218, USA
| | - J Emmerich
- Service de Médecine Vasculaire, Groupe Hospitalier Paris Saint-Joseph et Université Paris-Descartes, 185, rue Raymond-Losserand, 75014 Paris, France
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9
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Cervera-Bonilla S, Garcia Mora M, Rodriguez Ossa P, Messa O, Mendoza Díaz S. Medical Challenge Posed by Retroperitoneal Fibrosis: Case Reports and Literature Review. Cureus 2020; 12:e6624. [PMID: 32064203 PMCID: PMC7011588 DOI: 10.7759/cureus.6624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Idiopathic retroperitoneal fibrosis (RPF) is a rare fibro-inflammatory disease, with a low incidence worldwide, which occurs around the abdominal aorta and the iliac arteries. It spreads through the retroperitoneum causing ureteral obstruction with associated renal failure and obstruction of other adjacent structures. RPF can be idiopathic or secondary to neoplastic processes, infections, or medications. RPF is considered part of the spectrum of the disease related to immunoglobulin G4 (IgG4) and other autoimmune disorders. Occupational exposure to asbestos and tobacco smoke are important risk factors for the development of idiopathic RPF. The clinical picture is nonspecific, from pain to symptoms due to ureteral compression, this being the main complication associated. Imaging studies are essential in the diagnosis; computed tomography (CT) and magnetic resonance imaging (MRI) are the most reliable imaging modalities. The goal of treatment is to stop the progression of the fibroinflammatory reaction. The first line of treatment is usually with medical management. Biological agents, such as rituximab and infliximab, have also been used, even with scarce data in the literature. Surgery is usually performed to improve a ureteral obstruction and should always be accompanied by systemic steroid treatment. The conservative approach given by systemic therapy and ureteral stent placement or nephrostomies has been recommended, thus reserving surgical treatment for refractory cases. We present two clinical cases of idiopathic RPF, one of them associated with IgG4.
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Affiliation(s)
| | - Mauricio Garcia Mora
- Breast and Soft Tissue Surgery, Instituto Nacional de Cancerologia, Bogotá D.C., COL
| | - Paola Rodriguez Ossa
- Breast and Soft Tissue Surgery, Instituto Nacional de Cancerologia, Bogotá D.C., COL
| | - Oscar Messa
- Oncological Pathology, Instituto Nacional de Cancerologia, Bogotá D.C., COL
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10
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Renko AE, Mirkin KA, Cooper AB. Peritoneal encapsulation: a rare cause of small bowel obstruction. BMJ Case Rep 2019; 12:12/4/e228594. [PMID: 30992285 DOI: 10.1136/bcr-2018-228594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Peritoneal encapsulation syndrome (PES) is a rare cause of small bowel obstruction (SBO) in patients with no prior history of abdominal surgery. First described by Cleland in 1868, PES is a congenital condition characterised by small bowel encasement in an accessory, but otherwise normal peritoneal membrane. 1 2 A result of abnormal rotation of the midgut during early development, the condition causes fibrous encapsulation of the intestines, thus preventing bowel distention.3 While preoperative diagnosis is difficult, several case reports have described clinical and imaging signs that can help clinicians with not only recognising the condition but also preparing appropriately for perioperative discovery of anatomical variants. 3 4.
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Affiliation(s)
- Abagayle E Renko
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Katelin A Mirkin
- Department of Surgery, Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Amanda B Cooper
- Department of Surgery, Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
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11
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Renko AE, Witte SR, Cooper AB. Abdominal cocoon syndrome: an obstructive adhesiolytic metamorphosis. BMJ Case Rep 2019; 12:12/4/e228593. [PMID: 30975778 DOI: 10.1136/bcr-2018-228593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Abdominal cocoon syndrome (ACS), also known as idiopathic sclerosing peritonitis and primary sclerosing peritonitis, is a rare condition causing small bowel obstruction first described in 1978 by Foo et al It is characterised by total or partial encasement of the small bowel in a fibrocollagenous cocoon-like sac accompanied by extensive intrinsic small bowel adhesions. While the aetiology of this condition remains largely unknown, ACS can be divided into two subtypes: primary or idiopathic, which is often accompanied by cryptorchidism, and secondary to another cause such as congenital dysplasia or medications. Definitive diagnosis can only be achieved following laparotomy with extensive lysis of adhesions to alleviate the obstruction. However, preoperative diagnosis is possible if clinicians are aware of the condition and its radiologic signs.
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Affiliation(s)
- Abagayle E Renko
- The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Samantha R Witte
- Department of Surgery, Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Amanda B Cooper
- Department of Surgery, Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
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12
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Lomborg N, Jakobsen M, Bode CS, Junker P. IgG4-related disease in patients with newly diagnosed idiopathic retroperitoneal fibrosis: a population-based Danish study. Scand J Rheumatol 2019; 48:320-325. [DOI: 10.1080/03009742.2018.1551963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- N Lomborg
- Department of Rheumatology, Vejle Hospital, Vejle, Denmark
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - M Jakobsen
- Department of Pathology, Vejle Hospital, Vejle, Denmark
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | - CS Bode
- Department of Pathology, Odense University Hospital, Odense, Denmark
- Department of Pathology, Roskilde Hospital, Roskilde, Denmark
| | - P Junker
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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13
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Choi YK, Yang JH, Ahn SY, Ko GJ, Oh SW, Kim MG, Cho WY, Jo SK. Retroperitoneal fibrosis in the era of immunoglobulin G4-related disease. Kidney Res Clin Pract 2019; 38:42-48. [PMID: 30754935 PMCID: PMC6481977 DOI: 10.23876/j.krcp.18.0052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/10/2018] [Accepted: 10/24/2018] [Indexed: 12/16/2022] Open
Abstract
Background Retroperitoneal fibrosis (RPF) is a rare disease characterized by fibroinflammatory tissue in the periaortic or periiliac retroperitoneum, where it frequently encases ureters. There is emerging evidence that a subset of this disease is part of a spectrum of multisystemic autoimmune diseases collectively referred to as “immunoglobulin G4 (IgG4)-related disease”. Methods We retrospectively analyzed 27 idiopathic RPF patients and identified a subset as IgG4-related RPF, which we categorized according to recently published comprehensive diagnostic criteria. We compared clinical and laboratory characteristics and response to treatment between the two groups. Results Of 27 total patients, 16 (59.3%) were diagnosed as having IgG4-related RPF, and these were predominantly male. They were also significantly older and more likely to have other organ involvement, hydronephrosis, and postrenal acute kidney injury (AKI) compared to those with idiopathic RPF. However, there was no difference in response rate to systemic steroid treatment. Conclusion IgG4-related RPF accounts for a substantial portion of RPF cases previously identified as “idiopathic RPF” in Korea. Clinical and laboratory characteristics of IgG4-related RPF are similar to those of idiopathic RPF except for a striking male predominance, older age, and higher incidence of postrenal AKI in IgG4-related RPF. More comprehensive, prospective studies are needed to clearly distinguish IgG4-related RPF from idiopathic RPF based on clinical manifestation and to further assess treatment response and long-term prognosis.
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Affiliation(s)
- Yoon Kyung Choi
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Ji Hyun Yang
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Shin Young Ahn
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Gang Jee Ko
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
| | - Se Won Oh
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Myung Gyu Kim
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Won Yong Cho
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
| | - Sang Kyung Jo
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
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14
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Soriano Rios A, Paredes H, Hernández-Calleros J, Uscanga-Domínguez L, Peláez-Luna M. Retroperitoneal fibrosis. Steroid treatment response seems to depend on its association to IgG4 related disease. Med Hypotheses 2019; 122:120-123. [DOI: 10.1016/j.mehy.2018.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/06/2018] [Accepted: 11/14/2018] [Indexed: 02/04/2023]
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15
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Simopoulou T, Klimopoulos S, Sampaziotis D, Tzortziotis A, Bogdanos D, Sakkas LI. Inferior vena cava thrombosis as the initial presentation of IgG4-related retroperitoneal fibrosis: Case report and literature review. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2018; 3:NP1-NP6. [DOI: 10.1177/2397198318764793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/21/2018] [Indexed: 12/24/2022]
Abstract
IgG4-related disease is an immune-mediated deposition of fibro-inflammatory tissue with IgG4-positive plasma cells and dense fibrosis in a single or multiple organs. It often raises concern for malignancy requiring biopsy for diagnosis. Presentation may vary according to organ involved. IgG4-related retroperitoneal fibrosis accounts for two-thirds of the previously considered idiopathic retroperitoneal fibrosis cases. In IgG4-related retroperitoneal fibrosis, computed tomography scan or magnetic resonance imaging shows periaortic soft tissue that extends from below the kidneys to iliac arteries and entrap ureters causing hydronephrosis and renal failure. We present a rare case of IgG4-related retroperitoneal fibrosis presenting with leg swelling and pain due to inferior vena cava compression and thrombosis, and we review current concepts on disease pathogenesis, diagnosis and treatment.
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Affiliation(s)
- Theodora Simopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | | | | | - Apostolos Tzortziotis
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Dimitrios Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Lazaros I Sakkas
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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16
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Manganelli S, Giannitti C, Galeazzi M, Rossi M. Retroperitoneal fibrosis following a long-standing etanercept treatment in a spondyloarthritis patient. Joint Bone Spine 2017; 85:389-390. [PMID: 28600212 DOI: 10.1016/j.jbspin.2017.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 05/24/2017] [Indexed: 01/27/2023]
Affiliation(s)
- Stefania Manganelli
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci n(o)16, 53100 Siena, Italy.
| | - Chiara Giannitti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci n(o)16, 53100 Siena, Italy
| | - Mauro Galeazzi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci n(o)16, 53100 Siena, Italy
| | - Marco Rossi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Viale Bracci n(o)16, 53100 Siena, Italy
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17
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Rossi GM, Rocco R, Accorsi Buttini E, Marvisi C, Vaglio A. Idiopathic retroperitoneal fibrosis and its overlap with IgG4-related disease. Intern Emerg Med 2017; 12:287-299. [PMID: 28070877 DOI: 10.1007/s11739-016-1599-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 12/27/2016] [Indexed: 02/07/2023]
Abstract
Retroperitoneal fibrosis (RPF) is a rare disease characterised by fibrous tissue proliferation in the retroperitoneum, with encasement of the ureters and large vessels of the abdomen as the most destructive of potentially severe complications. It can either be idiopathic, or secondary to infections, malignancies, or the use of certain drugs. The idiopathic form accounts for approximately 75% of the cases, and is usually responsive to immunosuppressive therapy. In recent years, the emergence of a new clinical entity, IgG4-related disease (IgG4-RD), shed light on many fibro-inflammatory disorders once thought to be separate clinical entities, although frequently associated in the so-called multifocal fibrosclerosis. Among these, together with sclerosing pancreatitis and cholangitis, pseudotumour of the orbit, idiopathic mediastinal fibrosis and other conditions, is idiopathic retroperitoneal fibrosis (IRF). Both IRF and IgG4-RD can be associated with a wide variety of disorders, usually governed by immune-mediated (and particularly auto-immune) mechanisms. In our review, we discuss the clinical and therapeutic challenges IRF presents to the internist, as well as the meaning of its recent inclusion in the IgG4-RD spectrum from a clinical practice standpoint.
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Affiliation(s)
| | - Rossana Rocco
- Nephrology Unit, Parma University Hospital, Via Gramsci 14, 43126, Parma, Italy
| | | | - Chiara Marvisi
- Nephrology Unit, Parma University Hospital, Via Gramsci 14, 43126, Parma, Italy
| | - Augusto Vaglio
- Nephrology Unit, Parma University Hospital, Via Gramsci 14, 43126, Parma, Italy.
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18
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Yamakawa H, Sekine A, Yamanaka Y, Sadoyama S, Baba T, Hagiwara E, Okudela K, Ogura T. Pathologically Proven Spontaneous Remission of IgG4-related Retroperitoneal Fibrosis. Intern Med 2017; 56:1867-1871. [PMID: 28717084 PMCID: PMC5548681 DOI: 10.2169/internalmedicine.56.7996] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Some forms of idiopathic retroperitoneal fibrosis (RF) have recently been considered to be a part of the spectrum of immunoglobulin G4 (IgG4)-related disease. This case report is the first description of a spontaneous remission in a patient with pathologically proven IgG4-related RF. Although the pathogenesis and long-term disease behavior of IgG4-related RF remains unknown, we believe that an initial assessment consisting of only careful monitoring might be one important strategy, especially in asymptomatic IgG4-related RF patients without nephropathy, while carefully monitoring these patients for the risk of recurrence.
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Affiliation(s)
- Hideaki Yamakawa
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
- Department of Respiratory Medicine, Tokyo Jikei University Hospital, Japan
| | - Akimasa Sekine
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Yumie Yamanaka
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
- Department of Respiratory Medicine, Tokyo Jikei University Hospital, Japan
| | - Shinko Sadoyama
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Tomohisa Baba
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
| | - Koji Okudela
- Department of Pathobiology, Yokohama City University Graduate School of Medicine, Japan
| | - Takashi Ogura
- Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan
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19
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Fofi C, Prosperi D, Pettorini L, Festuccia F, Pirisino R, Lanni V, Scopinaro F, Punzo G, Menè P. Diagnosis and follow-up of idiopathic retroperitoneal fibrosis: role of (18)F-FDG-PET/CT and biochemical parameters in patients with renal involvement. Intern Emerg Med 2016; 11:809-16. [PMID: 26970988 DOI: 10.1007/s11739-016-1426-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/25/2016] [Indexed: 01/17/2023]
Abstract
Idiopathic retroperitoneal fibrosis (IRF) is a rare disease characterized by fibro-inflammatory reaction surrounding ureters and other inner organs with possible secondary renal involvement. Symptoms are aspecific and recurrent phases of activity are generally associated with elevation of inflammatory indices. 18F-FDG-PET is nowadays an important tool for the detection of this disease, allowing differentiation between metabolically active tissue and fibrotic one. The purpose of this study was to investigate the role of 18F-FDG-PET in the management of IRF and to evaluate possible correlations between biochemical parameters and PET/CT findings of disease activity. We enrolled seven consecutive patients with IRF (in five histology proved the disease) observed from 2003 to 2012 (5 M:2 F, mean age 53.8 years, range 44-86 years). All patients presented with fever as first symptom; two had obstructive renal failure requiring hemodialysis; one underwent monolateral nephrectomy for parenchyma infiltration; six presented ureteral involvement; three underwent ureteral stent placement. For each patient, during a mean total follow-up of 26.5 months we evaluated serum creatinine, BUN, Hb, RBCs, WBCs, PLT, CRP, ESR. Periodic 18F-FDG-PET/CT scans (every 5.9 months-mean) were performed in all patients. Statistical evaluation was performed using "stepwise regression" analysis. Steroids and immunosuppressive agents induced a progressive normalization of PET/CT scans in all patients at the end of follow-up. Stepwise regression analysis showed that BUN, serum creatinine and CRP only if considered together, significantly correlated with SUV max (p value = 0.000003057). 18F-FDG-PET is a useful tool for clinical decision making in patient with IRF, allowing to evaluate the efficacy of the pharmacological treatment and to detect early recurrences, to modify the therapeutic approach. Acute phase reactants are not reliable alone for the management and the follow-up as they are often not concordant with metabolic assessment of the disease. In patients with ureteral involvement, CRP together with BUN and serum creatinine has a significant correlation with PET/CT results, and can help physicians in therapeutic approach, better than a single parameter.
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Affiliation(s)
- Claudia Fofi
- Nephrology and Dialysis Unit, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy.
| | - Daniela Prosperi
- Department of Nuclear Medicine, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Laura Pettorini
- Nephrology and Dialysis Unit, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Francescaromana Festuccia
- Nephrology and Dialysis Unit, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Riccardo Pirisino
- Department of Nuclear Medicine, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Valerio Lanni
- Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy
| | - Francesco Scopinaro
- Department of Nuclear Medicine, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Giorgio Punzo
- Nephrology and Dialysis Unit, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Menè
- Nephrology and Dialysis Unit, Sant'Andrea Hospital, Second School of Medicine, Sapienza University of Rome, Rome, Italy
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20
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Alvarez Argote J, Bauer FA, Posteraro AF, Dasanu CA. Retroperitoneal fibrosis due to B-cell non-Hodgkin lymphoma: Responding to rituximab! J Oncol Pharm Pract 2016; 22:179-85. [PMID: 25013186 DOI: 10.1177/1078155214543279] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Retroperitoneal fibrosis is a rare disease manifesting as chronic soft tissue fibrosis in the retroperitoneum, with potential anatomic and/or functional compromise of adjacent organs. It can be primary (idiopathic) or secondary to other conditions such as cancers, autoimmune disorders, or drugs. We report herein a 66-year-old patient with symptomatic retroperitoneal fibrosis leading to bilateral hydronephrosis and renal failure, in whom, after a complex diagnostic work-up and protracted clinical course, a B-cell non-Hodgkin lymphoma in the retroperitoneal space and several vertebral bodies was identified. The patient was treated with radiation therapy and weekly rituximab infusions, with resolution of hydronephrosis and lower back pain. We include a thorough literature review on etiopathogenesis, diagnosis, therapy, and prognosis of retroperitoneal fibrosis. A meticulous search for malignancy is necessary in this rare condition that, if positive, may have significant therapeutic and prognostic implications.
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Affiliation(s)
| | - Frank A Bauer
- Department of Pathology, St. Francis Hospital and Medical Center, Hartford, USA
| | - Anthony F Posteraro
- Department of Radiology, St. Francis Hospital and Medical Center, Hartford, USA
| | - Constantin A Dasanu
- Department of Hematology-Oncology, St. Francis Hospital and Medical Center, Hartford, USA
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21
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Jeung S, Kim H, Seo Y, Yoon HY, Lee NK, Park S, Seo B, Park SY, Park SK. Rapidly resolved IgG4-related retroperitoneal fibrosis after steroid pulse therapy. Yeungnam Univ J Med 2016. [DOI: 10.12701/yujm.2016.33.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Soomin Jeung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyosang Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yuri Seo
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hee-Young Yoon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Nah Kyum Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Shinhee Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bomi Seo
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Su-Yeon Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Su-Kil Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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22
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Abstract
To describe clinical features and outcomes of 26 patients with idiopathic retroperitoneal fibrosis from a single center, we reviewed medical records of consecutive patients with idiopathic retroperitoneal fibrosis evaluated at our facility from January 1, 1998 to December 31, 2013 for clinical features, laboratory and radiographic findings, management, and outcomes. Twenty-six patients met criteria for idiopathic retroperitoneal fibrosis and were included in the study. Median age at diagnosis was 58 years; male-female ratio was 3.3:1.0. Median duration of symptoms was 7 weeks. Abdominal, flank, and/or low back pain were the most common presenting symptoms. Four patients (15 %) had associated autoimmune or fibrosing disorders. Baseline erythrocyte sedimentation rate was elevated in 17 (77 %) of 22 patients tested and C-reactive protein was elevated in 10 (56 %) of 18 patients tested. Hydronephrosis was present in 17 (68 %) patients; 8 (47 %) of 17 had bilateral hydronephrosis. Retroperitoneal mass biopsy was performed in 18 (69 %) patients. Two patients had idiopathic retroperitoneal fibrosis classifiable as IgG4-related disease. Therapy consisted of medications alone in 7 cases, surgical interventions alone in 7 cases, and a combination in 11 cases. One patient achieved remission with no treatment. Most patients treated medically received initial corticosteroids. Methotrexate (1 case), azathioprine (1 case), mycophenolate mofetil (1 case), and tamoxifen (5 cases) were used. No relapses occurred after a median 5-year follow-up. Two (8 %) patients died; five (19 %) developed cancer after diagnosis. In this series, we emphasize the importance of early diagnosis and therapy for overall favorable prognosis of idiopathic retroperitoneal fibrosis.
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23
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Najefi A, Alleemudder A, Mambu L, Jones S, Syed I, Gujral SS. Ureteral perigraft fistula: a case report and review of the literature. JOURNAL OF CLINICAL UROLOGY 2015. [DOI: 10.1177/2051415813516952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- A Najefi
- Urology Department, King George Hospital, UK
| | | | - L Mambu
- Urology Department, King George Hospital, UK
| | - S Jones
- Urology Department, King George Hospital, UK
| | - I Syed
- Urology Department, King George Hospital, UK
| | - SS Gujral
- Urology Department, King George Hospital, UK
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24
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Yang JH, Cho HJ, Kim JR, Kim HW, Yun HH. Idiopathic retroperitoneal fibrosis mimicking periprosthetic hip infection. J Orthop Sci 2015; 20:789-94. [PMID: 24504985 DOI: 10.1007/s00776-014-0532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Jae-Hyuk Yang
- Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Korea
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25
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Emmi G, Silvestri E, Squatrito D, Amedei A, Niccolai E, D'Elios MM, Della Bella C, Grassi A, Becatti M, Fiorillo C, Emmi L, Vaglio A, Prisco D. Thrombosis in vasculitis: from pathogenesis to treatment. Thromb J 2015; 13:15. [PMID: 25883536 PMCID: PMC4399148 DOI: 10.1186/s12959-015-0047-z] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 03/13/2015] [Indexed: 02/06/2023] Open
Abstract
In recent years, the relationship between inflammation and thrombosis has been deeply investigated and it is now clear that immune and coagulation systems are functionally interconnected. Inflammation-induced thrombosis is by now considered a feature not only of autoimmune rheumatic diseases, but also of systemic vasculitides such as Behçet’s syndrome, ANCA-associated vasculitis or giant cells arteritis, especially during active disease. These findings have important consequences in terms of management and treatment. Indeed, Behçet’syndrome requires immunosuppressive agents for vascular involvement rather than anticoagulation or antiplatelet therapy, and it is conceivable that also in ANCA-associated vasculitis or large vessel-vasculitis an aggressive anti-inflammatory treatment during active disease could reduce the risk of thrombotic events in early stages. In this review we discuss thrombosis in vasculitides, especially in Behçet’s syndrome, ANCA-associated vasculitis and large-vessel vasculitis, and provide pathogenetic and clinical clues for the different specialists involved in the care of these patients.
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Affiliation(s)
- Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy
| | - Elena Silvestri
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy
| | - Danilo Squatrito
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy.,SOD Interdisciplinary Internal Medicine, Center for Autoimmune Systemic Diseases-Behçet Center and Lupus Clinic-AOU Careggi Hospital of Florence, Florence, Italy
| | - Elena Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy
| | - Mario Milco D'Elios
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy.,SOD Interdisciplinary Internal Medicine, Center for Autoimmune Systemic Diseases-Behçet Center and Lupus Clinic-AOU Careggi Hospital of Florence, Florence, Italy
| | - Chiara Della Bella
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy
| | - Alessia Grassi
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy
| | - Matteo Becatti
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Claudia Fiorillo
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Lorenzo Emmi
- SOD Interdisciplinary Internal Medicine, Center for Autoimmune Systemic Diseases-Behçet Center and Lupus Clinic-AOU Careggi Hospital of Florence, Florence, Italy
| | - Augusto Vaglio
- Nephrology Unit, University Hospital of Parma, Parma, Italy
| | - Domenico Prisco
- Department of Experimental and Clinical Medicine, University of Florence, L.go G. Brambilla, 3, 50134 Florence, Italy.,SOD Interdisciplinary Internal Medicine, Center for Autoimmune Systemic Diseases-Behçet Center and Lupus Clinic-AOU Careggi Hospital of Florence, Florence, Italy
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26
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Liang W, Xu S. Imaging-based Evaluation of Retroperitoneal Fibrosis: A Challenge for Radiologists. Radiology 2015; 274:937-8. [DOI: 10.1148/radiol.14141682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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27
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Solmaz A, Tokoçin M, Arıcı S, Yiğitbaş H, Yavuz E, Gülçiçek OB, Erçetin C, Çelebi F. Abdominal cocoon syndrome is a rare cause of mechanical intestinal obstructions: a report of two cases. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:77-80. [PMID: 25671606 PMCID: PMC4335564 DOI: 10.12659/ajcr.892658] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Case series Patient: Male, 30 • Male, 47 Final Diagnosis: Abdominal cocoon syndrome Symptoms: Abdominal pain • nausea • vomiting Medication: — Clinical Procedure: Operation Specialty: Surgery
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Affiliation(s)
- Ali Solmaz
- General Surgery Clinic, Bagcılar Training and Education Hospital, Istanbul, Turkey
| | - Merve Tokoçin
- General Surgery Clinic, Bagcılar Training and Education Hospital, Istanbul, Turkey
| | - Sinan Arıcı
- General Surgery Clinic, Bagcılar Training and Education Hospital, Istanbul, Turkey
| | - Hakan Yiğitbaş
- General Surgery Clinic, Bagcılar Training and Education Hospital, Istanbul, Turkey
| | - Erkan Yavuz
- General Surgery Clinic, Bagcılar Training and Education Hospital, Istanbul, Turkey
| | | | - Candaş Erçetin
- General Surgery Clinic, Bagcılar Training and Education Hospital, Istanbul, Turkey
| | - Fatih Çelebi
- General Surgery Clinic, Bagcılar Training and Education Hospital, Istanbul, Turkey
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28
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Mishra K, Zargar H, Tarplin S, Ramanathan R, Stein RJ. Idiopathic retroperitoneal fibrosis. J Urol 2015; 193:1657-8. [PMID: 25659660 DOI: 10.1016/j.juro.2015.01.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Kirtishri Mishra
- Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Homayoun Zargar
- Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sarah Tarplin
- Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rajan Ramanathan
- Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert J Stein
- Glickman Urological Institute, Cleveland Clinic, Cleveland, Ohio
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29
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Oh YJ, Lee WS, Kang MH, Hwang JH, Yoo WH. Retroperitoneal Fibrosis in a Patient with Rheumatoid Arthritis. JOURNAL OF RHEUMATIC DISEASES 2015. [DOI: 10.4078/jrd.2015.22.6.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yoo-Jeong Oh
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Won-Seok Lee
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Mi-Hee Kang
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Joo-Hee Hwang
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Wan-Hee Yoo
- Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Hospital, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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30
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Lee HS, Park JE, Nam SW, Shim KY, Kang T. Idiopathic Retroperitoneal Fibrosis Associated with Rheumatoid Arthritis in a Patient with Concomitant Chronic B Viral Hepatitis. JOURNAL OF RHEUMATIC DISEASES 2015. [DOI: 10.4078/jrd.2015.22.2.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Hyang Sun Lee
- Department of Rheumatology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jeong Eun Park
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seoung Wan Nam
- Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kwang Yong Shim
- Department of Haemato-Oncology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Taeyoung Kang
- Department of Rheumatology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
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31
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Urban ML, Palmisano A, Nicastro M, Corradi D, Buzio C, Vaglio A. Idiopathic and secondary forms of retroperitoneal fibrosis: a diagnostic approach. Rev Med Interne 2014; 36:15-21. [PMID: 25455951 DOI: 10.1016/j.revmed.2014.10.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/13/2014] [Indexed: 10/24/2022]
Abstract
Retroperitoneal fibrosis (RPF) is an uncommon disease characterized by a fibrous reaction that takes place in the peri-aortic retroperitoneum and often entraps the ureters causing obstructive uropathy. RPF is idiopathic in the majority of cases, but can also be secondary to malignancies, infections, drugs, radiotherapy, and rare histiocytic disorders such as Erdheim-Chester disease. Idiopathic RPF is an immune-mediated disease, which can either be isolated, associated with other autoimmune diseases, or arise in the context of a multifocal fibro-inflammatory disorder recently renamed as IgG4-related disease. The differential diagnosis between idiopathic, IgG4-related and secondary RPF is crucial, essentially because the therapeutic approaches - especially of idiopathic vs. secondary RPF - can be dramatically different. This review focuses on the clinical, laboratory and imaging features of the different RPF forms, and also provides an overview of the available treatment options.
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Affiliation(s)
- M L Urban
- Unit of nephrology, university hospital, Parma, Italy
| | - A Palmisano
- Unit of nephrology, university hospital, Parma, Italy
| | - M Nicastro
- Unit of nephrology, university hospital, Parma, Italy
| | - D Corradi
- Section of pathology and laboratory medicine, department of biomedical, biotechnological and translational sciences, university hospital, Parma, Italy
| | - C Buzio
- Unit of nephrology, university hospital, Parma, Italy
| | - A Vaglio
- Unit of nephrology, university hospital, Parma, Italy.
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Ruiz XD, Levesque MC, Modi SR, Mock GD, Liang KP. 20-year-old amish woman with abdominal pain, retroperitoneal mass, and hyperlipidemia. Arthritis Care Res (Hoboken) 2014; 67:447-51. [PMID: 25073796 DOI: 10.1002/acr.22425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 07/22/2014] [Indexed: 11/08/2022]
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Brandt AS, Kamper L, Kukuk S, Haage P, Roth S. Tamoxifen monotherapy in the treatment of retroperitoneal fibrosis. Urol Int 2014; 93:320-5. [PMID: 25073896 DOI: 10.1159/000357814] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/06/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the therapeutic effect of tamoxifen monotherapy in patients with retroperitoneal fibrosis (RPF). PATIENTS AND METHODS From 2007 on, 31 patients with idiopathic RPF were treated with tamoxifen monotherapy. Follow-up investigations included magnetic resonance imaging, laboratory measurements, registration of side effects and changes or removal of ureteral stents. Data were stored in the Else Kröner-Fresenius Registry of Retroperitoneal Fibrosis. RESULTS 25 men and 6 women with a mean age of 56.6 years were treated with tamoxifen monotherapy. Mean duration of treatment was 13.3 months, mean follow-up 26.8 months. A total of 44 renal units were affected by hydronephrosis and covered by DJ stents. Radiological regression of fibrosis was detected in 22 cases (71.0%); removal of ureteral stents was possible in 27/44 renal units (61.4%) and 17/29 patients (58.6%), respectively. Most patients showed only mild or no side effects of therapy. In 7 cases (22.3%) tamoxifen therapy had to be abandoned because of severe side effects, progression of fibrosis or persistent intolerance. CONCLUSIONS Tamoxifen is an alternative in the medical treatment of RPF, especially if patients want to avoid glucocorticoids. The potential of regression of fibrosis seems to be slightly inferior and the relapse rate is higher compared to steroids, but the rate of successful DJ removals is comparable.
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Affiliation(s)
- Alexander Sascha Brandt
- Department of Urology, HELIOS Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
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Pieringer H, Parzer I, Wöhrer A, Reis P, Oppl B, Zwerina J. IgG4- related disease: an orphan disease with many faces. Orphanet J Rare Dis 2014; 9:110. [PMID: 25026959 PMCID: PMC4223520 DOI: 10.1186/s13023-014-0110-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/03/2014] [Indexed: 02/07/2023] Open
Abstract
Immunoglobulin G4- related disease (IgG4-RD) is a rare systemic fibro-inflammatory disorder (ORPHA284264). Although patients have been described more than 100 years ago, the systemic nature of this disease has been recognized in the 21st century only. Type 1 autoimmune pancreatitis is the most frequent manifestation of IgG4-RD. However, IgG4-RD can affect any organ such as salivary glands, orbits, retroperitoneum and many others. Recent research enabled a clear clinical and histopathological description of IgG4-RD. Typically, lymphoplasmacellular inflammation, storiform fibrosis and obliterative phlebitis are found in IgG4-RD biopsies and the tissue invading plasma cells largely produce IgG4. Elevated serum IgG4 levels are found in many but not all patients. Consequently, diagnostic criteria for IgG4-RD have been proposed recently. Treatment is largely based on clinical experience and retrospective case series. Glucocorticoids are the mainstay of therapy, although adjunctive immunosuppressive agents are used in relapsing patients. This review summarizes current knowledge on clinical manifestations, pathophysiology and treatment of IgG4-RD.
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Schmidt WA. Role of ultrasound in the understanding and management of vasculitis. Ther Adv Musculoskelet Dis 2014; 6:39-47. [PMID: 24688604 DOI: 10.1177/1759720x13512256] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Vasculitis is characterized by a circumferential vessel-wall thickening ('halo'), which can be visualized by modern imaging techniques. In particular, the resolution of ultrasound has increased to 0.1 mm. Ultrasound detects abnormalities that are pathognomonic even in arteries with a diameter below 1 mm. It is particularly helpful in the diagnosis of large-vessel vasculitides, such as classic temporal arteritis, large-vessel giant-cell arteritis (GCA), Takayasu arteritis and idiopathic aortitis. Echocardiography is important for determining cardiac involvement in Takayasu arteritis and also for examining the coronary arteries of children with suspected Kawasaki disease, which is a medium-vessel vasculitis. In small vessel vasculitides ultrasound has only a role for determining the distribution or organ involvement. Fast-track clinics for the diagnosis of GCA help to initiate treatment before complications such as blindness occur; patients receive appointments within 24 h in these clinics. Clinical examination and ultrasound of temporal and axillary arteries are performed by an experienced rheumatologist. In most cases this is able to determine if GCA is present. Temporal artery biopsy can be still carried out in ambivalent cases. The wall swelling of temporal arteries disappears after 2-3 weeks of glucocorticoid treatment. After 3 days of treatment, diagnosis becomes more difficult with ultrasound in some cases. In larger arteries, such as the axillary arteries, wall thickening disappears within months. It tends to be darker (more hypoechoic) in acute disease because of oedema.
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Affiliation(s)
- Wolfgang A Schmidt
- Immanuel Krankenhaus Berlin, Medical Centre for Rheumatology Berlin-Buch, Lindenberger Weg 19, 13125 Berlin, Germany
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Yamakawa H, Yoshida M, Katagi H, Hirooka S, Okuda K, Ishikawa T, Takagi M, Kuwano K. Pulmonary and retroperitoneal lesions induced by methotrexate-associated lymphoproliferative disorder in a patient with rheumatoid arthritis. Mod Rheumatol 2014; 26:441-4. [PMID: 24684409 DOI: 10.3109/14397595.2014.898559] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A 78-year-old man had fatigue and appetite loss for 5 months. He had been receiving low-dose methotrexate for rheumatoid arthritis. Computed tomography revealed multiple pulmonary infiltrations and muddiness of the fatty tissue surrounding the right kidney, ureter wall thickening, and hydroureter/nephrosis, which were suspected retroperitoneal fibrosis. Lung biopsy revealed polymorphic/lymphoplasmacytic lymphoproliferative disorder. Methotrexate withdrawal resulted in spontaneous regression. Therefore, retroperitoneal lesion may account for the diagnosis as having retroperitoneal lymphoproliferative disorder, not retroperitoneal fibrosis.
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Affiliation(s)
- Hideaki Yamakawa
- a Department of Respiratory Medicine , Jikei University School of Medicine, Kashiwa Hospital , Chiba , Japan
| | - Masahiro Yoshida
- a Department of Respiratory Medicine , Jikei University School of Medicine, Kashiwa Hospital , Chiba , Japan
| | - Hiroaki Katagi
- b Department of Diagnostic Pathology , Jikei University School of Medicine, Kashiwa Hospital , Chiba , Japan
| | - Shinichi Hirooka
- b Department of Diagnostic Pathology , Jikei University School of Medicine, Kashiwa Hospital , Chiba , Japan
| | - Keitaro Okuda
- a Department of Respiratory Medicine , Jikei University School of Medicine, Kashiwa Hospital , Chiba , Japan
| | - Takeo Ishikawa
- a Department of Respiratory Medicine , Jikei University School of Medicine, Kashiwa Hospital , Chiba , Japan
| | - Masamichi Takagi
- a Department of Respiratory Medicine , Jikei University School of Medicine, Kashiwa Hospital , Chiba , Japan
| | - Kazuyoshi Kuwano
- c Division of Respiratory Diseases, Department of Internal Medicine , Jikei University School of Medicine , Tokyo , Japan
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Nagayama M, Yanagawa Y, Aihara K, Watanabe S, Takemoto M, Nakazato T, Hashimoto T, Takayama T, Takazawa Y, Iba T, Kaneko K, Tanaka H. Analysis of non-traumatic truncal back pain in patients who visited an emergency room. Acute Med Surg 2014; 1:94-100. [PMID: 29930829 DOI: 10.1002/ams2.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 11/15/2013] [Indexed: 01/27/2023] Open
Abstract
AIM To investigate epidemiology of acute non-traumatic back pain using modern diagnostic methods in patients who visited an emergency room. METHODS The medical charts were retrospectively reviewed for all patients with back pain who were treated in our hospital. In addition, the patients were divided into two groups based on whether they were treated at the hospital or as outpatients. RESULTS There were 95 patients with non-traumatic acute back pain. Leading cause of back pain was ureterolithiasis (53 cases), followed by pyelonephritis (10), orthopedic disease including two cases of purulent spondylitis (24), aortic disease (3), pancreatitis (1), renal bleeding (1), adrenal bleeding (1), psoas abscess (1), and torsion of an ovarian tumor (1). All cases of pyelonephritis, aortic disease, purulent spondylitis, renal bleeding, adrenal bleeding, psoas abscess, and torsion of an ovarian tumor were treated in admission. Using a multiple logistic regression analysis, blood pressure, age, and body temperature were the only factors that were independently associated with whether the patient was admitted or treated as an outpatient. CONCLUSION This study showed that urological diseases are the most common cause of back pain in patients who visit the emergency room, followed by orthopedic disease. Older age, low blood pressure, and high body temperature were independently associated with the decision to admit the patient who might have lethal disease.
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Affiliation(s)
- Masataka Nagayama
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Youichi Yanagawa
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Koichiro Aihara
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Shin Watanabe
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Masaaki Takemoto
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Tomoko Nakazato
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Takashi Hashimoto
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Toshio Takayama
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Yuuji Takazawa
- Department of Orthopedics Juntendo University Tokyo Japan
| | - Toshiaki Iba
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
| | - Kazuo Kaneko
- Department of Orthopedics Juntendo University Tokyo Japan
| | - Hiroshi Tanaka
- Department of Emergency and Disaster Medicine Juntendo University Tokyo Japan
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COUDERC MARION, MATHIEU SYLVAIN, DUBOST JEANJACQUES, SOUBRIER MARTIN. Retroperitoneal Fibrosis During Etanercept Therapy for Rheumatoid Arthritis. J Rheumatol 2013; 40:1931-3. [DOI: 10.3899/jrheum.130324] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Schmidt WA. Imaging in vasculitis. Best Pract Res Clin Rheumatol 2013; 27:107-18. [PMID: 23507061 DOI: 10.1016/j.berh.2013.01.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 12/09/2012] [Accepted: 12/21/2012] [Indexed: 11/17/2022]
Abstract
Vasculitides may involve small, medium-sized or large arteries. In small-vessel vasculitides imaging studies of lungs, nasal sinuses, cerebrum, heart and other organs are important for determining disease extension and disease activity. Aneurysms are a hallmark of medium-sized artery vasculitides. In large-vessel vasculitis, imaging studies depict homogeneous, circumferential wall swelling and smoothly tapered luminal narrowing. Ultrasound and high-resolution magnetic resonance imaging (MRI) show characteristic wall abnormalities in temporal and occipital arteries whereas ultrasound, MRI, MR angiography, computed tomography (CT), CT angiography and positron emission tomography delineate characteristic features in extra-cranial arteries that are affected in large-vessel giant cell arteritis, Takayasu arteritis and idiopathic aortitis. Conventional angiography has still its place for therapeutic interventions. Imaging has led to a better understanding of the nature and distribution of vasculitides. It significantly facilitates diagnosis of patients with suspected vasculitis.
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Affiliation(s)
- Wolfgang A Schmidt
- Immanuel Krankenhaus Berlin, Medical Centre for Rheumatology Berlin-Buch, Lindenberger Weg 19, 13125 Berlin, Germany.
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Treglia G, Stefanelli A, Mattoli MV, Leccisotti L, Muoio B, Bertagna F. Usefulness of (18)F-FDG PET/CT in Evaluating Disease Activity at Different Times in a Patient With Chronic Periaortitis. Nucl Med Mol Imaging 2012; 47:69-71. [PMID: 24895514 DOI: 10.1007/s13139-012-0185-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 10/16/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022] Open
Affiliation(s)
- Giorgio Treglia
- Institute of Nuclear Medicine, Department of Bioimaging and Radiological Sciences, Catholic University of the Sacred Heart, Rome, Italy ; Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Largo Gemelli, 8, 00168 Rome, Italy
| | - Antonella Stefanelli
- Institute of Nuclear Medicine, Department of Bioimaging and Radiological Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Vittoria Mattoli
- Institute of Nuclear Medicine, Department of Bioimaging and Radiological Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Lucia Leccisotti
- Institute of Nuclear Medicine, Department of Bioimaging and Radiological Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Barbara Muoio
- School of Medicine, Catholic University of the Sacred Heart, Rome, Italy
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