Current approach to diagnosis and management of retroperitoneal fibrosis.

Published on Mar 12, 2020in International Journal of Urology2.445
· DOI :10.1111/IJU.14218
Toshiaki Tanaka16
Estimated H-index: 16
(Sapporo Medical University),
Naoya Masumori37
Estimated H-index: 37
(Sapporo Medical University)
Sources
Abstract
Retroperitoneal fibrosis is characterized by fibrotic lesions around the abdominal aorta and common ileac artery causing ureteral obstruction. Secondary retroperitoneal fibrosis is associated with malignant disease, drugs, exposure to radiation and surgery. In contrast, the majority of retroperitoneal fibrosis is classified into idiopathic retroperitoneal fibrosis, for which immunological etiology has been suggested. Recently, idiopathic retroperitoneal fibrosis has been considered to be a spectrum of immunoglobulin G4-related disease, a systemic inflammatory disease, the concept of which has been developed during the past decade. In the management of retroperitoneal fibrosis, assessment of systemic lesions associated with immunoglobulin G4-related disease and the exclusion of secondary retroperitoneal fibrosis is mandatory. Histological examination of retroperitoneal lesions is desired for accurate diagnosis and management. Laparoscopic or open biopsy is often beneficial, although it is more invasive than needle biopsy. Treatment for idiopathic retroperitoneal fibrosis consists of meticulous glucocorticoid therapy based on that for immunoglobulin G4-related disease, which is expected to be highly effective. Ureteral obstruction is usually managed with conservative procedures, such as ureteral stenting or percutaneous nephrostomy. The goal of treatment for retroperitoneal fibrosis should be freedom from the stent/nephrostomy with withdrawal of the glucocorticoid in addition to salvage of renal function; however, conservative management does not always provide favorable outcomes. In contrast, aggressive surgical treatment, such as ureterolysis, can achieve the goal; however, the procedure is associated with high morbidity. Establishment of a consensus about treatment for idiopathic retroperitoneal fibrosis, including the optimal indications for the invasive surgical procedure and conservative management, is desired.
References50
Newest
#1Jungen Tang (HUST: Huazhong University of Science and Technology)H-Index: 3
#2Shaozhe Cai (HUST: Huazhong University of Science and Technology)H-Index: 3
Last. Lingli Dong (HUST: Huazhong University of Science and Technology)H-Index: 16
view all 4 authors...
Abstract Objective ImmunoglobulinG4-related disease (IgG4-RD) is a recently recognized disease and, as such, there is a pressing need to identify biomarkers for diagnosis, monitoring disease activity, and predicting prognosis and response to therapy. Here, we review the recent development and identification of biomarkers for IgG4-RD. Methods Through extensive literature review and analysis, we updated the biomarkers for IgG4-RD and further put forward our own viewpoints. Results In addition to t...
7 CitationsSource
#1Maria Letizia Urban (UniFI: University of Florence)H-Index: 13
#2Federica Maritati (UniFI: University of Florence)H-Index: 13
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Chronic periaortitis (CP) is a rare condition characterised by a peri-aortoiliac fibro-inflammatory tissue. A total of 20%–50% of the cases are immunoglobulin G4 (IgG4)-related, based on histological evidence of IgG4+ plasma cell infiltration (on a background of dense lymphoplasmacytic infiltrates, storiform fibrosis and tissue eosinophilia) and/or increased serum IgG4.1 Glucocorticoids are the first-line therapy for CP.2 However, some patients are refractory, frequently relapsing or have contra...
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#1Tong Chen (SJTU: Shanghai Jiao Tong University)H-Index: 1
#1T. Chen (SJTU: Shanghai Jiao Tong University)H-Index: 1
Last. S. Ding (SDU: Shandong University)H-Index: 1
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Purpose Accumulated evidences have reminded us that since the prognosis of retroperitoneal fibrosis (RPF) secondary to non-urology carcinoma is poor it is essential to distinguish this condition from others. The objective of this study is to investigate the clinical features and outcomes of this infrequent but life-threatening disease.
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#1Rachel WallworkH-Index: 6
#2Zachary S. WallaceH-Index: 25
Last. John H. StoneH-Index: 76
view all 5 authors...
AbstractRetroperitoneal fibrosis (RPF) refers to a fibro-inflammatory lesion in the retroperitoneum, often anterolateral to the aorta. Most cases are due to IgG4-related disease (IgG4-RD) or are idiopathic. RPF can lead to severe morbidity. Treatment strategies remain poorly-defined. We evaluated th
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#1Jinah KimH-Index: 1
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Last. Yoon Mi Jeen (SCH: Soonchunhyang University)H-Index: 5
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#1Tim O'Brien (Guy's and St Thomas' NHS Foundation Trust)H-Index: 27
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Objective To determine the outcomes of open ureterolysis in a contemporary cohort of patients presenting with ureteric obstruction secondary to retroperitoneal fibrosis (RPF). Patients and methods We conducted a prospective analysis of 50 patients undergoing open ureterolysis and omental wrap between January 2012 and January 2016 in a single centre, managed by a multi-disciplinary RPF team. Patients had a minimum follow-up of 1 year. Indications were: nephrostomy-dependent drainage (n = 5); sten...
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#1Hisanori UmeharaH-Index: 43
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AbstractIgG4-related disease (IgG4-RD) is a fascinating clinical entity proposed by Japanese investigators, and includes a wide variety of diseases, formerly diagnosed as Mikulicz's disease (MD), autoimmune pancreatitis (AIP), interstitial nephritis, prostatitis, retroperitoneal fibrosis, etc. Although all clinicians in every field of medicine may encounter this new disease, a unifying diagnostic criterion has not been established. In 2011, the Japanese IgG4 team, organized by the Ministry of He...
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