Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2017 Aug;10(3):157-159.
doi: 10.1159/000447172. Epub 2017 Jul 30.

An Atypical Presentation of Retroperitoneal Fibrosis

Wei Phin Tan  1 , Thomas Hwang  1 , Robert Medairos  1 , Dennis A Pessis  1
Affiliations
Case Reports

An Atypical Presentation of Retroperitoneal Fibrosis

Wei Phin Tan et al. Curr Urol. 2017 Aug.

Abstract

A 69-year-old man with a psoriatic arthritis treated with infliximab for 1 month presented to the urology clinic for lower urinary tract symptoms. He was found to have a new diagnosis of elevated creatinine. Computed tomography of the abdomen and pelvis revealed bilateral severe hydronephrosis with abnormal soft tissue thickening of the right renal pelvis and proximal ureter. Bilateral stents were placed after ureteroscopy demonstrated no abnormalities. A computed tomography-guided biopsy of the peri-ureteral lesions revealed fibroadipose tissue with sclerosis and extensive chronic inflammation consistent with retroperitoneal fibrosis. Infliximab was discontinued and the patient was started on corticosteroids. Follow-up magnetic resonance imaging of the abdomen and pelvis at 2 months revealed total resolution of soft tissue and inflammation along the proximal ureter bilaterally. Repeat imaging demonstrated no hydronephrosis after stents removal, and the patient's creatinine remains normal at 12 months follow-up.

Keywords: Hydronephrosis; Idiopathic fibrosis; Infliximab; Mesenteric sclerosis; Retroperitoneal fibrosis.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
CT of the abdomen and pelvis (contrast phase). Arrow depicts chronic inflamation and fibroadipose tissue.
Fig. 2
Fig. 2
MRI of the abdomen and pelvis. A is upon initial presentation. B is after treatment with corticosteroid.
See this image and copyright information in PMC

References

    1. Amis ES., Jr Retroperitoneal fibrosis. AJR Am J Roentgenol. 1991;157:321–329. - PubMed
    1. Lepor H, Walsh PC. Idiopathic retroperitoneal fibrosis. J Urol. 1979;122:1–6. - PubMed
    1. Vaglio A, Salvarani C, Buzio C. Retroperitoneal fibrosis. Lancet. 2006;367:241–251. - PubMed
    1. Corradi D, Maestri R, Palmisano A, Bosio S, Greco P, Manenti L, Ferretti S, Cobelli R, Moroni G, Dei Tos AP, Buzio C, Vaglio A. Idiopathic retroperitoneal fibrosis: clinicopathologic features and differential diagnosis. Kidney Int. 2007;72:742–753. - PubMed
    1. Catanoso MG, Spaggiari L, Magnani L, Pipitone N, Versari A, Boiardi L, Pazzola G, Pattacini P, Salvarani C. Efficacy of infliximab in a patient with refractory idiopathic retroperitoneal fibrosis. Clin Exp Rheumatol. 2012;30:776–778. - PubMed

Publication types