Retroperitoneal Fibrosis: Case Series of 20 Patients
Science Journal of Public Health
Volume 5, Issue 4, July 2017, Pages: 294-300
Received: Mar. 29, 2017; Accepted: Apr. 12, 2017; Published: Jun. 13, 2017
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Kaddouri Said, Department of Internal Medicine, Ibn Sina Military Hospital, Marrakesh, Morocco
Ghoundale Omar, Department of Urology, Ibn Sina Military Hospital, Marrakesh, Morocco
Chahbi Zakaria, Department of Internal Medicine, Ibn Sina Military Hospital, Marrakesh, Morocco
Essadi Ismail, Department of Medical Oncology, Ibn Sina Military Hospital, Marrakesh, Morocco
Qacif Hassan, Department of Internal Medicine, Ibn Sina Military Hospital, Marrakesh, Morocco
Zamraoui Nadir, Department of Nephrology, Ibn Sina Military Hospital, Marrakesh, Morocco
Zyani Mohamed, Department of Internal Medicine, Ibn Sina Military Hospital, Marrakesh, Morocco
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Retroperitoneal fibrosis (RPF) is a rare disease. The objective of this paper is to study the prevalence, clinical, biological and radiological aspects of the RPFand to specify its therapeutic modalities. This study provides descriptive evidence for a series of 20 patients with RPF. We conducted a retrospective study of cases of RPF diagnosed in the Urology and Internal Medicine departments of the Ibn Sina Military Hospital in Marrakech over a five-year period from July 2010 to December 2015. The positive diagnosis of RPF was retained either on the basis of a histological analysis from a biopsy fragment or, in the absence of histological evidence, by the detection on a scan of an infiltrate or "sleeve" Regular and homogeneous tissue density, perivascular topography, surrounding the abdominal aorta, more or less extended to the iliac vessels and able to take the contrast after injection. They were 15 men and 5 women with an average age of 53 years with extremes of 41 to 74 years. Almost all patients had mainly lumbar and abdominal pain. An inflammatory syndrome existed in all cases and renal insufficiency in 15 cases. Radiological investigations showed unilateral or bilateral hydronephrosis in 16 cases. RPF was idiopathic in 14 patients. Secondary forms were present in 6 patients (three atheromatous diseases, one gastric tumor, one case associated with Riedel's thyroiditis and one case of systemic fibrosis associating RPF, Riedel's thyroiditis and liver fibrosis). The treatment consisted of corticosteroids in 19 cases, surgery in 17 cases associated with corticosteroid therapy or even immunosuppressant in the case of steroid-dependence. Two deaths were observed in this series; one of these two patients had developed cervix carcinoma with pleural and peritoneal metastases after 5 years of immunosuppressive therapy. The second died due to the complications of his gastric neoplasm. The general characteristics of patients included are similar to the other series of the literature. The frequency of secondary forms seems to be underestimated, hence the value of a rigorous etiological investigation. The therapeutic strategy and the use of the cortisone saving treatments should be specified by randomized therapeutic trials. The prognosis is generally good; however, the possibility of recurrences, the incidence of which is greater during the first five years, requires prolonged clinical, biological and radiological monitoring.
Retroperitoneal Fibrosis, Atheroma, Neoplasm, Vasculitis, Riedel's Thyroiditis, Corticosteroids
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Kaddouri Said, Ghoundale Omar, Chahbi Zakaria, Essadi Ismail, Qacif Hassan, Zamraoui Nadir, Zyani Mohamed, Retroperitoneal Fibrosis: Case Series of 20 Patients, Science Journal of Public Health. Vol. 5, No. 4, 2017, pp. 294-300. doi: 10.11648/j.sjph.20170504.13
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