title: Medical management of retroperitoneal fibrosis.
abstract: BACKGROUND
  Small series and case reports suggest that a combination of mycophenolate mofetil and prednisone is an efficatious and safe treatment for patients with retroperitoneal fibrosis.
  
  
  OBJECTIVE
  To describe the outcomes of patients with retroperitoneal fibrosis treated with a combination of prednisone and mycophenolate mofetil.
  
  
  METHODS
  Prospective, case series.
  
  
  METHODS
  31 patients with retroperitoneal fibrosis.
  
  
  METHODS
  Single-center tertiary care facility.
  
  
  METHODS
  Prednisone 40 mg administered daily and tapered over 6 months and mycophenolate mofetil 1,000 mg given twice daily.
  
  
  METHODS
  Clinical course, laboratory assessment, measurement of periaortic mass.
  
  
  RESULTS
  Systemic symptoms resolved in all patients. Eighty-nine percent of patients had a 25% or greater reduction in periaortic mass. Eighteen patients had 32 obstructed ureters. Thirty of these ureters were free of obstruction after an average of 513 days of therapy. Laboratory abnormalities of elevated erythrocyte sedimentation rate and serum creatinine and decreased hemoglobin levels normalized in all patients. Recurrent disease occurred in 2 of 28 patients.
  
  
  CONCLUSIONS
  Combined prednisone and mycophenolate mofetil appears to be an effective therapeutic option for patients with retroperitoneal fibrosis.
authors.affiliation: PScheel1@jhmi.edu
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Scheel
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Sozio
authors.forename: Nancy
authors.initials: N
authors.lastname: Feeley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001018:Aortic Diseases / Q000188:drug therapy; D019468:Disease Management; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use*; D011446:Prospective Studies; D012185:Retroperitoneal Fibrosis / Q000188:drug therapy*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D009173:Mycophenolic Acid; D011241:Prednisone