title: Retroperitoneal disorders associated with IgG4-related autoimmune pancreatitis.
abstract: IgG4-related autoimmune pancreatitis is frequently accompanied by relevant lesions in the genitourinary tract and retroperitoneal organs, which cause various clinical problems, ranging from non-specific back pain or bladder outlet obstruction to renal failure. The diagnosis of IgG4-related retroperitoneal fibrosis requires a multidisciplinary approach, including serological tests, histological examination, imaging analysis, and susceptibility to steroid therapy. Radiological examinations are helpful to diagnose this condition, but surgical resection is occasionally unavoidable to exclude malignancy, particularly for patients with isolated retroperitoneal involvement. Steroid therapy is the treatment of choice for this condition, the same as for other manifestations of IgG4-related disease. For patients with severe ureteral obstruction, additional ureteral stenting needs to be considered prior to steroid therapy to preserve the renal function. Some papers have suggested that IgG4-related disease can affect male reproductive organs including the prostate and testis. IgG4-related prostatitis usually causes lower urinary tract symptoms, such as dysuria and pollakisuria. Patients sometimes state that corticosteroids given for IgG4-related disease at other sites relieve their lower urinary tract symptoms, which leads us to suspect prostatic involvement in this condition. Because of the limited number of publications available, further studies are warranted to better characterize IgG4-related disease in male reproductive organs.
authors.affiliation: Noboru Hara, Keisuke Takeda, Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Hara
authors.affiliation: Noboru Hara, Keisuke Takeda, Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawaguchi
authors.affiliation: Noboru Hara, Keisuke Takeda, Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Noboru Hara, Keisuke Takeda, Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D003952:Diagnostic Imaging / Q000379:methods; D052776:Female Urogenital Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D052801:Male Urogenital Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D011237:Predictive Value of Tests; D012185:Retroperitoneal Fibrosis / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy; D012307:Risk Factors; D012737:Sex Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D007074:Immunoglobulin G
keywords: Autoimmune pancreatitis; Genitourinary tract; IgG4; Management; Retroperitoneum