title: Immunoglobulin G4-Related Retroperitoneal Fibrosis Treated with Hochuekkito, a Kampo Medicine, following Steroid Treatment.
abstract: We report a case of immunoglobulin G4 (IgG4)-related retroperitoneal fibrosis (RF) with complete remission and no relapses after therapy with steroids and Hochuekkito, a Kampo (i.e. traditional Japanese herbal) medicine. A 62-year-old Japanese man was admitted to our hospital for treatment of a retroperitoneal mass detected by computed tomography. The mass had a maximum diameter of 11.0 cm; it involved the left ureter and was associated with left hydronephrosis. After inserting a ureteral stent, we performed a biopsy by laparotomy. Histopathology revealed IgG4-related RF. The lesion disappeared after 7 months of steroid therapy. We subsequently used Hochuekkito as an alternative maintenance treatment because of steroid-related complications. The patient has not relapsed in the 3 years since starting the medication. To the best of our knowledge, this is the first case of IgG4-related RF treated with Hochuekkito as a maintenance treatment.
authors.affiliation: Department of Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.affiliation: Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Sakurai
authors.affiliation: Department of Japanese Oriental Medicine, Gunma Chuo Hospital, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kogure
authors.affiliation: Department of Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Naitoh
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
keywords: Hochuekkito; IgG4-related retroperitoneal fibrosis; Steroid