المؤلفون: Gallo, A¹ (AUTHOR) antonella.gallo@policlinicogemelli.it, Agnitelli, MC¹ (AUTHOR), Pellegrino, S¹ (AUTHOR), Calcagni, ML^2,3 (AUTHOR), Montalto, M^1,4 (AUTHOR)

المصدر: Scandinavian Journal of Rheumatology. Sep2023, Vol. 52 Issue 5, p574-576. 3p.

مصطلحات موضوعية: *HELICOBACTER pylori infections, *RETROPERITONEAL fibrosis, *ETIOLOGY of diseases, *INFORMED consent (Medical law), *LUMBAR pain

مستخلص: This is the first case of a patient with a histological diagnosis of RPF achieving complete remission of the disease after eradication of H. pylori infection. Lumbosacral spine magnetic resonance imaging showed periaortic tissue of uncertain significance at the L3 level, and computed tomography (CT) showed hypodense tissue surrounding the subrenal aorta for 8 cm. To rule out a malignant aetiology, endoscopic evaluation was performed. Retroperitoneal fibrosis (RPF), a rare disease characterized by fibroinflammatory tissue around the infrarenal portion of the abdominal aorta and iliac arteries, is classified into primary (or idiopathic) and secondary forms ([1]). [Extracted from the article]

المؤلفون: El-deen Anwar, Dalia Salah¹ dodoradiology@gmail.com, Abdelhay AbdelKadir, Rabab Mohamed¹

المصدر: Zagazig University Medical Journal. Mar2023, Vol. 29 Issue 2, p525-531. 7p.

مصطلحات موضوعية: *COMPUTED tomography, *RETROPERITONEAL fibrosis, *RADIOGRAPHS, *LYMPH nodes, *METASTASIS

مستخلص: Background: This study aimed to assess the accuracy of multi-detector computed tomography (MDCT) in the diagnosis of different retroperitoneal masses by comparing with the pathology results of the studied cases. Cases of suspected retroperitoneal masses by ultrasound, MDCT is the reference standard for them, it shows up the accurate diagnosis, location, extent of the tumor, along with the involvement of adjacent organs and vessels. It also has high accuracy in the differentiation of malignant from benign lesions, detection of lymph node involvement & metastasis. Therefore, MDCT plays an important role in treatment planning and follow-up of different retroperitoneal masses. MDCT has many Advantages over other imaging modalities: less invasive, more widely available, lower dose of radiation, higher spatial & temporal resolution Methods: This study was carried out at Radiodiagnosis Department, Zagazig University Hospitals, and other radiological centers. The present study was carried on 42 patients with retroperitoneal masses. Those patients were examined by MDCT. Results: The MDCT images of 42 patients were analyzed for reaching the final diagnosis. The results of MDCT were compared with the histopathological results. Positive results were obtained in 37 lesions out of a total of 42 cases, with estimated CT accuracy of about 88.1% in the diagnosis of different retroperitoneal masses. Conclusions: MDCT should be used in the first place in the course of diagnostic and staging procedures of patients with different retroperitoneal tumors and tumor recurrence. [ABSTRACT FROM AUTHOR]

المؤلفون: Giannese, Domenico¹ (AUTHOR), Moriconi, Diego¹ (AUTHOR), Cupisti, Adamasco¹ (AUTHOR), Zucchi, Alessandro² (AUTHOR), Pastore, Antonio Luigi³ (AUTHOR), Simonato, Alchiede⁴ (AUTHOR), Mogorovich, Andrea⁵ (AUTHOR), Claps, Francesco⁶ (AUTHOR), Bartoletti, Riccardo² (AUTHOR)

المصدر: Urologia Internationalis. Feb2023, Vol. 107 Issue 2, p134-147. 14p.

مصطلحات موضوعية: *RETROPERITONEAL fibrosis, *KIDNEY physiology, *URETERIC obstruction, *SURGICAL stents, *NEPHROSTOMY, *SURGICAL robots

مستخلص: Background: The aim of this study was to investigate the long-term effects of ureteral stenting and the exact timing of stent removal in favor of surgery in patients with idiopathic retroperitoneal fibrosis (IRF). Summary: Medline research terms of "idiopathic retroperitoneal fibrosis" AND " medical therapy" OR "ureteral stenting" OR "surgical treatment" were done. Systematic reviews and observational and clinical studies were analyzed to obtain indication regarding the objective of the study for a narrative review. Ninety-two papers were analyzed. The treatment of IRF includes the monitoring of retroperitoneal fibrotic process spread and the prevention of abdominal organs entrapment. Treatment of ureteral obstruction includes medical therapy and ureteral stenting (US) or percutaneous nephrostomy (PNS) to overcome the worsening of renal function. Up to now, the timing of US or PNS removal is not yet clear, both for the complexity of evaluating the efficacy of the medical therapy and demonstrating the resolution of obstructive nephropathy. Moreover, it is not yet clear if the long-term ureteral stent placement or PNS is able to maintain an efficient renal function. Ureterolysis with a laparoscopic robot-assisted approach is now considered as an ultimate treatment for ureteral obstruction, limiting the progression of kidney impairment and improving the quality of life of patients, although nephrologists are generally abdicant regarding the potential switch toward the surgical approach. Key Messages: Prospective studies regarding the long-term effects of US on the renal function impairment in patients with IRF should be structured to obtain adequate information on the exact timing for the surgical approach. [ABSTRACT FROM AUTHOR]

المؤلفون: Zhao, Juan¹ (AUTHOR), Zhang, Zhuoli¹ (AUTHOR) zhuoli.zhang@126.com

المصدر: Clinical Rheumatology. Feb2023, Vol. 42 Issue 2, p591-595. 5p.

مصطلحات موضوعية: *RETROPERITONEAL fibrosis, *RENAL fibrosis, *URETERIC obstruction, *ABDOMINAL aorta, *PULMONARY fibrosis, *IMMUNOSUPPRESSIVE agents

مستخلص: Idiopathic retroperitoneal fibrosis (iRPF) is a chronic autoimmune disease characterized by fibroinflammatory tissue surrounding the abdominal aorta and iliac arteries and extending into the retroperitoneum to envelop neighboring structures. Hydronephrosis due to obstruction of ureters is the most common complication of iRPF. Glucocorticoid with or without immunosuppressants or tamoxifen, the mainstay of iRPF treatment, usually brings good response. Nevertheless, in some conditions, the obstruction of ureters remains unresolved with the treatment of all these medications. One of the reasons lies in the innate feature of the fibroinflammatory tissue. The proliferation of fibrosis tissue in addition to inflammation in the mass was associated with insufficient response to immunosuppressive therapies. Pirfenidone, an anti-fibrosis agent, has been successful in treating pulmonary fibrosis and renal fibrosis. Therefore, it is rationale to assume the effectiveness of pirfenidone in the treatment of iRPF. In the current article, we report a 61-year-old Chinese man with iRPF who responded well to pirfenidone. [ABSTRACT FROM AUTHOR]

المؤلفون: Muller, Romain¹ (AUTHOR), Ebbo, Mikael¹ (AUTHOR), Habert, Paul^2,3 (AUTHOR), Daniel, Laurent⁴ (AUTHOR), Briantais, Antoine¹ (AUTHOR), Chanez, Pascal⁵ (AUTHOR), Gaubert, Jean Yves⁶ (AUTHOR), Schleinitz, Nicolas¹ (AUTHOR) nicolas.schleinitz@ap-hm.fr

المصدر: Respirology. Feb2023, Vol. 28 Issue 2, p120-131. 12p.

مصطلحات موضوعية: *OTOLARYNGOLOGY, *RETROPERITONEAL fibrosis, *ANTIRHEUMATIC agents, *COMPUTED tomography, *DISEASE incidence, *DIAGNOSIS methods

مستخلص: Immunoglobulin G4‐related disease (IgG4‐RD) is a recently described rare systemic fibroinflammatory disease with an estimated incidence of less than 1 in 100,000 persons per year. The disease can affect virtually any organ and is characterized by unifying histopathological findings. Recently, four subgroups of patients have been characterized: hepatobiliary, head and neck, Mikulicz syndrome and retroperitoneal fibrosis, who illustrate the mainly abdominal and ENT tropism of the disease. Yet, thoracic involvement is not uncommon. It can be detected in up to 30% of patients with systemic IgG4‐RD and is the exclusive manifestation of the disease in about 10% of cases. Clinical symptoms are nonspecific and may include dyspnoea, cough or chest pain. Chest CT findings are heterogeneous and primarily include peribronchovascular thickening, nodules, ground‐glass opacities and lymphadenopathy. There is no specific diagnostic test for IgG4‐RD thoracic involvement, which may mimic malignancy or vasculitis. Therefore, a cautious approach is needed to make an accurate diagnosis: a search for extra‐thoracic manifestations, elevated serum IgG4 levels, circulating levels of plasmablasts and pathologic evidence of disease is warranted. Although very suggestive, neither the presence of a polyclonal IgG4 lymphoplasmacytic infiltrate, storiform fibrosis or obliterative phlebitis are sufficient to confirm the histological diagnosis. Steroids are recommended as first‐line therapy. Rituximab or disease‐modifying antirheumatic drugs may be used in relapsed or rare cases of steroid‐refractory disease. In this review, we summarize current knowledge regarding the pathophysiology, epidemiology, diagnostic modalities (clinical–biological–imaging–histopathology) and treatment of IgG4‐RD thoracic involvement. [ABSTRACT FROM AUTHOR]

المؤلفون: Mohd Ilyas, Shwait Sharma, Vikrant Gupta

المصدر: South African Journal of Radiology, Vol 28, Iss 1, Pp e1-e5 (2024)

مصطلحات موضوعية: immunoglobulin g4-related disease, ct, mri, retroperitoneal fibrosis, aorta, ureter, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Immunoglobulin G4 (IgG4)-related disease has the potential to impact any part of the body, including the walls of large- and medium-sized blood vessels and the ureters. While histopathologic examination is currently the standard method for identifying organ involvement and diagnosing IgG4-related disease (IgG4-RD), obtaining biopsy or surgical samples from vessel or ureteral walls is challenging. Given that patients may display only mild symptoms, non-invasive imaging plays a vital role in both diagnosing and managing IgG4-related diseases. Multidetector CT scans are valuable in establishing the primary diagnosis, identifying anatomical landmarks and assessing their relationships. Involvement of the genitourinary organs, such as the ureter, bladder, urethra, and male and female reproductive organs in IgG4-RD, is infrequent when compared to kidney involvement. The imaging findings may include the presence of a localised mass within or surrounding the affected organ or a generalised enlargement of the organ. This report includes cross-sectional images of five cases of IgG4-RD involving large- and medium-sized blood vessels (the aorta and superior mesenteric artery) and the ureters. Contribution: This case series provides insight into the various imaging appearances of IgG4-related retroperitoneal organ involvement and helps differentiate it radiologically from retroperitoneal fibrosis.

وصف الملف: electronic resource

العلاقة: https://sajr.org.za/index.php/sajr/article/view/2830Test; https://doaj.org/toc/1027-202XTest; https://doaj.org/toc/2078-6778Test

الوصول الحر: https://doaj.org/article/f8a4cb2a0b1849a2a879ad9a48e60eb8Test

المؤلفون: Wu, Jun¹ (AUTHOR), Li, Jushuang¹ (AUTHOR), Feng, Baohong¹ (AUTHOR), Bi, Zhimin¹ (AUTHOR), Zhu, Geli¹ (AUTHOR), Zhang, Yanxia¹ (AUTHOR), Li, Xiangyou¹ (AUTHOR) lixiangyou3@163.com

المصدر: Renal Failure. Dec2022, Vol. 44 Issue 1, p1546-1558. 13p.

مصطلحات موضوعية: *PERITONEAL dialysis, *RETROPERITONEAL fibrosis, *MITOCHONDRIA, *PEROXISOME proliferator-activated receptors, *MITOCHONDRIAL DNA, *AMP-activated protein kinases

مستخلص: The pathogenesis of peritoneal dialysis (PD)-related peritoneal fibrosis (PF) is not clearly understood, and current treatment options are limited. In this study, the effect of PD-related PF on mitochondrial biogenesis was investigated, and the effect of activation of the adenosine monophosphate-activated protein kinase (AMPK)-PGC-1α (peroxisome proliferator-activated receptor γ coactivator-1α) pathway on PF was evaluated in mice. In a mouse model of PD-related PF, AMPK-PGC-1α signaling (phospho-AMPK, PGC-1α, NRF-1, NRF-2 and TFAM expression) was downregulated, mitochondrial DNA (mtDNA) levels were reduced, and mitochondrial structure was damaged in the peritoneum. In addition, TdT-mediated dUTP nick-end labeling (TUNEL) staining showed typical apoptosis characteristics in peritoneal mesothelial cells (PMCs). Activation of the AMPK-PGC-1α pathway (PGC-1α overexpression or metformin, which is an agonist of AMPK) upregulated phospho-AMPK, PGC-1α, nuclear respiratory factors 1 (NRF-1) and 2 (NRF-2), and mitochondrial transcription factor A (TFAM) expression and mtDNA content, improved mitochondrial morphological manifestations, inhibited apoptosis of PMCs and alleviated PF. Our study may suggest that activation of the AMPK-PGC-1α pathway ameliorates PD-related PF by enhancing mitochondrial biogenesis. [ABSTRACT FROM AUTHOR]

المؤلفون: Łoń, Izabela¹ (AUTHOR), Lewandowski, Jacek¹ (AUTHOR), Wieliczko, Monika² (AUTHOR), Małyszko, Jolanta² (AUTHOR)

المصدر: Renal Failure. Dec2022, Vol. 44 Issue 1, p688-692. 5p. 2 Black and White Photographs, 1 Chart.

مصطلحات موضوعية: *RETROPERITONEAL fibrosis, *CARDIOVASCULAR diseases risk factors, *BLOOD cholesterol, *KIDNEY physiology, *RARE diseases

مستخلص: Retroperitoneal fibrosis (RPF) is a rare disease associated with the formation of hard inflammatory and fibrous tissue in the retroperitoneum. Taking into consideration the fact that RPF is a rare disease with different subtypes, we compared the basal clinical and biochemical characteristics of the vascular and urorenal subtypes. From January 2005 until December 2021, 27 patients were identified as vascular subtype (18 males) and 11 as urorenal subtype (9 males). Patients with a primary urorenal origin had significantly worse kidney function as reflected by serum creatinine and eGFR (both p < 0.001); they also had higher serum cholesterol (p < 0.01). Hypertension, diabetes, hyperlipidemia and nicotinism were significantly more prevalent in vascular subtype (all p < 0.001). Vascular subtype is more prevalent in our study with more cardiovascular risk factor present. Due to the diversity of symptoms, diagnosis of RPF becomes a challenge for specialists as well as therapy. [ABSTRACT FROM AUTHOR]

المؤلفون: Takashi Nawata^1,2, Yuko Ota¹ y-ota@nms.ac.jp, Mita Sakuraba¹, Mikito Suzuki¹, Takahisa Gono¹, Mitsuhiro Takeno¹, Masataka Kuwana¹

المصدر: Journal of Nippon Medical School. 2022, Vol. 89 Issue 6, p612-615. 4p.

مصطلحات موضوعية: *RETROPERITONEAL fibrosis, *ULTRASONIC imaging, *POSITRON emission tomography, *MAGNETIC resonance imaging, *ILIAC artery, *KIDNEY failure

مستخلص: Periaortitis is a rare vascular manifestation and is often associated with retroperitoneal fibrosis. Herein, we describe a case of periaortitis accompanied by retroperitoneal fibrosis in a patient who developed acute kidney insufficiency due to bilateral ureteral stenosis. Ultrasonography at presentation detected thickness of the outer layer of the bilateral common iliac artery and right internal and external iliac arteries, consistent with periaortitis. Moreover, follow-up ultrasound images revealed subsiding of the thickness of the arterial wall in response to treatment with corticosteroids. Because of its noninvasiveness and handiness, ultrasonography has become popular for the assessment of large vessels in clinical practice, particularly monitoring for affected lesions. Computed tomography, magnetic resonance imaging, and positron emission tomography are currently used for the diagnosis and monitoring of periaortitis, but in this case, ultrasonography was utilized in the diagnosis and monitoring of periaortitis as a supportive imaging modality, as the use of contrast agents was contraindicated because of renal insufficiency. [ABSTRACT FROM AUTHOR]

المؤلفون: Ilki, Fahri Yavuz¹ (AUTHOR) yavuzilki@gmail.com, Bulbul, Emre¹ (AUTHOR), Gultekin, Mehmet Hamza¹ (AUTHOR), Citgez, Sinharib¹ (AUTHOR), Demirdag, Cetin¹ (AUTHOR), Ozden, Sami Berk¹ (AUTHOR), Onal, Bulent¹ (AUTHOR)

المصدر: Journal of Endourology. Nov2022, Vol. 36 Issue 11, p1425-1430. 6p.

مصطلحات موضوعية: *RETROPERITONEAL fibrosis, *LAPAROSCOPIC surgery, *URETERIC obstruction, *SURGICAL stents, *MEDICAL records

مستخلص: Objectives: To compare the surgical outcomes of open and laparoscopic ureterolysis procedures in patients requiring surgical treatment for ureteral obstruction caused by retroperitoneal fibrosis (RPF). Materials: This study was designed retrospectively. The clinical records of patients who underwent ureterolysis between January 2005 and April 2019 because of ureteral obstruction caused by RPF were examined. According to the type of surgery, the patients were divided into two groups as Group 1 (open ureterolysis) and Group 2 (laparoscopic ureterolysis). Demographic features, preoperative–postoperative renal functions, duration of follow-up with ureteral stents, and perioperative–postoperative complications were examined. The requirement of ureteral stent placement during the follow-up period was accepted as unsuccessful ureterolysis. Results: Ureterolysis was performed in 13 patients and 23 renal units. Eleven of these patients were men and two were women. The median age of the patients was 54 (44–68) years. There were six patients and 12 renal units in Group 1 and seven patients and 11 renal units in Group 2. Postoperatively, a total of four patients (30%) had minor complications (Clavien–Dindo 1–2) and one patient had a major complication (Clavien–Dindo 3a). Ureterolysis was determined to be effective in 21 of the renal units (91%) [11/12 (92%) in Group 1 vs 10/11 (91%) in Group 2]. No statistically significant difference was found between the groups in terms of the success and complication rates (p = 1 and p = 0.529, respectively). Postoperative hospitalization length and recovery time to return to normal preoperative activities were significantly shorter in Group 2 than in Group 1 (p = 0.011 and p = 0.041, respectively). Conclusions: The success and complication rates were similar between the open and laparoscopic methods for ureterolysis. Laparoscopic approach was advantageous over open approach in terms of postoperative hospitalization length and recovery time to return to normal preoperative activities. [ABSTRACT FROM AUTHOR]