Review of retroperitoneal fibrosis

The Bottom Line:— There are idiopathic and secondary forms of retroperitoneal fibrosis, with the former accounting for over 70 percent of cases . Idiopathic disease most commonly occurs in individuals 40 to 60 years of age, with a 2 to 3:1 male-to-female predominance. In its early stages it typically presents with nonspecific abdominal and low back pain with systemic symptoms. In its later stages (when it is usually diagnosed) it presents with ureteral obstruction

Cronin, Carmel Retroperitoneal fibrosis: a review of clinical features and imaging findings. AJR, American journal of roentgenology 2008 vol:191 iss:2 pg:423 -431

A variety of secondary causes of retroperitoneal fibrosis have also been identified:

1- Drugs – ergot-derivatives, methysergide (which, in the past, was widely used for the prevention of migraine headaches) bromocriptine, beta blockers, methyldopa, hydralazine, analgesics
2- Malignancy – carcinoid, Hodgkin’s and non-Hodgkin lymphoma, sarcomas
3- Infections – tuberculosis, histoplasmosis, actinomycosis
4- Radiation therapy for testicular seminoma, colon, pancreatic cancer
5- Surgery – lymphadenectomy, colectomy, aortic aneurysmectomy

In addition, there are reports of cases in association with secondary (AA) amyloidosis, trauma, barium enema, mesenteric panniculitis and different forms of histiocytosis, particularly Erdheim-Chester disease.

Repost from 2/6/12 – VA

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