[Idiopathic retroperitoneal fibrosis: combined steroid and endourologic treatment].
Review of 7 patients with idiopathic retroperitoneal fibrosis (IRF), treated with a combination of corticosteroids (6-methyl-prednisolone) and endourological procedures. The presentation symptom was lumbar pain in all 7 cases. Mean creatinine (Cr) levels were 5.4 mg/dl, with mean erythrocyte sedimentation rate (ESR) of 114. Three (43%) patients were positive to rheumatoid factor (RF) and had raised IgG. Definite diagnosis was achieved in all cases by CAT, including puncture biopsy in 1; all 7 (100%) cases were bilateral. With an average follow-up of 3 years, clinical evolution is satisfactory in all 7 cases. Mean control Cr is 1.2 mg/dl and mean ESR 19. CAT showed disappearance of fibrotic plaque in all cases. One patient relapsed when maintenance therapy was discontinued but responded again to a new therapy course. No steroid therapy-related complications were seen. The association of conservative steroid therapy and endourological procedures is a very low morbidity, sensible alternative in the management of benign retroperitoneal fibrosis where CAT and MNR are the primary diagnostic techniques.
Gómez Veiga
F
F
Servicio de Urología, Hospital Juan Canalejo, La Coruña.
Chantada Abal
V
V
Sousa Escandón
A
A
Rodríguez García
J
J
Sánchez Rodríguez
J
J
González Martín
M
M
D000328:Adult; D000368:Aged; D000465:Algorithms; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D012185:Retroperitoneal Fibrosis / Q000175:diagnosis / Q000628:therapy*
D008775:Methylprednisolone
Fibrosis retroperitoneal idiopática: tratamiento combinado esteroideo y endourológico.