Juxtaglomerular cell tumor with retroperitoneal fibrosis and secondary immune-complex glomerulonephritis: A possible contribution of the renin angiotensin system to renal fibrosis

Erectile dysfunction and Peyronie's disease in patient with retroperitoenal fibrosis

OBJECTIVE

The aim of this study is to determine the sexual dysfunction in patient with retroperitoneal fibrosis (RPF) and also we explored probability of Peyronie's disease (PD) in this patient group and to compare this with the controls.

MATERIALS AND METHODS

Ten of 17 male RPF patients formed the basis of this study. Patient's age, concomitant diseases were recorded. The diagnosis of PD was based on a palpable penile plaque or acquired penile curvature. Age-matched 88 patients who were admitted to our outpatient clinic with elevated PSA level served as the control group. All patients were asked to complete the IIEF-5 questionnaire. The severity of the erectile dysfunction (ED) was classified into four categories: severe (5-7), moderate (8-16), mild (17-21), and no ED (22-25). Concomitant systemic diseases were recorded. Statistical analyses were done by the Fisher's exact test and an unpaired-sample t-test.

RESULTS

Patients with severe ED or no sexual intercourse in the study group and the control group during the study period were found to be 7 and 14, respectively. The median IIEF-5 score in RPF patients and the control group was 9.8 (min: 5 to max: 23) and 19 (min: 5 to max: 25), respectively. The differences between groups were statistically significant (P = 0.002). In particular, ED was reported in eight RPF patients (80%) which was severe in six (60%) and moderate in two (20%). ED was reported in 45 patients in the control group (51%) which was severe in 14 (15.9%), mild in 25 (28.4%), and moderate in six (6.8%). Patients with RPF had a significant tendency for severe ED compared with the control group (P = 0.0042). Two patients in the RPF group (20%) and one patient in the control group (1.1%) were found to have a penile plaque (P = 0.0279). Relative risk for developing a penile plague was found to be 0.8 in RPF.

CONCLUSION

RPF patients are found to be more prone to developing ED. Penile plaque formation was identified in RPF patients, which may be presumed to relate to the pathological changes of the RPF process, but it remains unclear that these patients demonstrate a higher incidence of plaque formation than the normal population.

Myocardial infarction in a young female with reninoma induced hypertension and myocardial bridging

We present a case of myocardial infarction in a young female with reninoma induced hypertension and myocardial bridging. Reninoma is a rare and curable cause of secondary hypertension. Currently developed multi-detector computed tomography (MDCT) has permitted better evaluation of myocardial infarction and myocardial bridging. Myocardial infarction associated with reninoma and myocardial bridging has not been reported, and we report this interesting case.

[Renin-secreting tumour: about a new diagnosed case during pregnancy]

A 29 year-old female patient developed severe arterial hypertension in the beginning of her second pregnancy. Investigations performed at 16 weeks of amenorrhea showed hypokaliemia in relation to severe hyperreninism: plasma active renin was 25 fold normal value, 94% as prorenin (prorenin representing 94% of total renin). Radiological investigations including ultrasonography and MRI disclosed an homogenous and avascular tumor in the right kidney. Its ablation confirmed renin tumor, and allowed recovery from HTA and continuation of pregnancy. This is the 75th reported case in the literature, enabling to make a new statement about diagnostic and therapeutic procedures, which are modified during pregnancy by contra-indication to X-rays and renin-angiotensin-aldosteron axis inhibitors.