title: Retroperitoneal fibrosis with periaortic and pericardial involvement.
abstract: A 66-year old man, who had been diagnosed with dilated cardiomyopathy and felt a progressive shortness of breath and fatigability, was admitted to hospital. Computed tomography showed a thickening of the aortic wall from the aortic arch to the aortic bifurcation, as well as mild pleural and pericardial effusion. Intravenous pyelography showed severe ureteral stenosis, along with hydronephrosis, of the left side. There was a marked increase in C-reactive protein and the erythrocyte sedimentation rate, but the serology for connective tissue disease and perinuclear antineutrophil cytoplasmic antibodies was negative. Retroperitoneal fibrosis (RPF) with intrathoracic extension was diagnosed. After confirming the absence of malignant disease, an oral predonisolone treatment of 30 mg/day was started, and this ameliorated the ureteral obstruction, aortic wall thickening and pericardial effusion. The patient had been taking 300 mg of loxoprofen sodium for headaches every day for 16 years. The relationship between loxoprofen, cardiomyopathy and RPF remains unclear. There is a possibility of RPF in the patients with a thickening of thoracic aortic wall, as in this case.
authors.affiliation: Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Amiya
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
authors.forename: Airi
authors.initials: A
authors.lastname: Watanabe
authors.forename: Yoko
authors.initials: Y
authors.lastname: Endo
authors.forename: Rei
authors.initials: R
authors.lastname: Itou
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Yoshida
authors.forename: Masahumi
authors.initials: M
authors.lastname: Nangaku
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage*; D001011:Aorta; D006801:Humans; D008297:Male; D010496:Pericardium / Q000000981:diagnostic imaging; D010666:Phenylpropionates / Q000009:adverse effects; D011239:Prednisolone / Q000008:administration & dosage*; D011859:Radiography; D012185:Retroperitoneal Fibrosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018931:Antineoplastic Agents, Hormonal; D010666:Phenylpropionates; C040656:loxoprofen; D011239:Prednisolone