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Review
. 2021 Feb 10;23(3):18.
doi: 10.1007/s11926-020-00966-9.

Into Clinical Practice: Diagnosis and Therapy of Retroperitoneal Fibrosis

Paride Fenaroli  1   2 , Federica Maritati  3 , Augusto Vaglio  4   5   6
Affiliations
Review

Into Clinical Practice: Diagnosis and Therapy of Retroperitoneal Fibrosis

Paride Fenaroli et al. Curr Rheumatol Rep. .

Abstract

Purpose of the review: We aim to review the most relevant diagnostic features and treatment options of retroperitoneal fibrosis, in order to provide a useful guide for clinical practice.

Recent findings: The recent literature highlights the role of imaging studies such as computed tomography, magnetic resonance imaging and positron emission tomography as useful tools for the diagnosis of retroperitoneal fibrosis, with retroperitoneal biopsy being reserved to atypical cases. The treatment approach is mainly conservative and is based on the use of medical therapies plus urological interventions. Medical therapies essentially comprise glucocorticoids and immunosuppressants-either traditional or biological agents such as rituximab. Surgical ureterolysis is only left for refractory cases. Recent findings in retroperitoneal fibrosis highlight the possibility of a non-invasive diagnostic approach and a conservative treatment strategy.

Keywords: Autoimmunity; Glucocorticoids; IgG4; PET; Retroperitoneal fibrosis; Rituximab.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Vaglio A, Salvarani C, Buzio C. Retroperitoneal fibrosis. Lancet. Jan 21 2006;367(9506):241–51.
    1. van Bommel EF, Jansen I, Hendriksz TR, Aarnoudse AL. Idiopathic retroperitoneal fibrosis: prospective evaluation of incidence and clinicoradiologic presentation. Medicine (Baltimore). Jul 2009;88(4):193–201.
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    1. Corradi D, Maestri R, Palmisano A, Bosio S, Greco P, Manenti L, et al. Idiopathic retroperitoneal fibrosis: clinicopathologic features and differential diagnosis. Kidney Int. Sep 2007;72(6):742–53. https://doi.org/10.1038/sj.ki.5002427 . - DOI - PubMed
    1. Palmisano A, Vaglio A. Chronic periaortitis: a fibro-inflammatory disorder. Best Pract Res Clin Rheumatol. Jun 2009;23(3):339–53. - PubMed

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