급성 신부전과 흉수를 동반한 원발성 후복막강 섬유화증 1예 = A Case of Idiopathic Retroperitoneal Fibrosis with Acute Renal Failure and a Pleural Effusion

다국어 초록 (Multilingual Abstract)

Idiopathic retroperitoneal fibrosis (IRF) is characterized by a fibrotic process and chronic inflammation of the retroperitoneal area and aorta. The development of retroperitoneal inflammation and fibrosis often results in periureteral encasement, ureteral obstruction, acute renal failure, and subsequent chronic renal failure and, rarely, mediastinal, pericardial, or pleural involvement. Our patient presented with left flank pain and abdominal computed tomography (CT) showed a retroperitoneal mass encompassing the aorta and both ureters. IRF was diagnosed after a biopsy of the retroperitoneal mass. A complicating left pleural effusion and acute renal failure developed and the patient underwent a percutaneous nephrostomy and was treated with prednisolone. After this, the patient’s symptoms, renal failure, and pleural effusion improved and the retroperitoneal mass decreased in size. We report a case of IRF with a pleural effusion and acute renal failure that improved with steroid treatment, with a literature review. (Korean J Med 2011;80:S263-S267)

국문 초록 (Abstract)

저자들은 50세 남자 환자에서 요관 폐쇄에 의한 급성 신부전과 편측성 흉수를 동반한 원발성 후복막강 섬유화증을 진단하고, 요관내 카테터 삽입술을 시행받았으나 신부전 악화되어 경피적 신루술 및 steroid 투여 후에 급성 신부전 및 편측성 흉수의 호전을 보인 1예 경험하였기에 문헌고찰과 함께 보고하는 바이다.

참고문헌 (Reference)

1 이경해, "급성 신부전으로 발현된 특발성 후복막 섬유증의 스테로드 치료 1예" 대한신장학회 23 (23): 649-654, 2004

2 Koep L, "The clinical significance of retroperitoneal fibrosis" 81 : 250-257, 1977

3 Dedeoglu F, "Successful treatment of retroperitoneal fibrosis with tamoxifen in a child" 28 : 1693-1695, 2001

4 Cronin CG, "Retroperitoneal fibrosis: a review of clinical features and imaging findings" 191 : 423-431, 2008

5 Amiya E, "Retroperitoneal fibrosis with periaortic and pericardial involvement" 69 : 760-762, 2005

6 Harreby M, "Retroperitoneal fibrosis treated with methylprednisolon pulse and disease-modifying antirheumatic drugs" 28 : 237-242, 1994

7 Reilly RF Jr, "Retroperitoneal fibrosis presenting as acute renal failure" 1 : 55-59, 2005

8 van Bommel EF, "Retroperitoneal fibrosis" 60 : 231-242, 2002

9 Vaglio A, "Retroperitoneal fibrosis" 367 : 241-251, 2006

10 Warnatz K, "Immunosuppressive treatment of chronic periaortitis: a retrospective study of 20 patients with chronic periaortitis and a review of the literature" 64 : 828-833, 2005

11 Marcolongo R, "Immunosuppressive therapy for idiopathic retroperitoneal fibrosis: a retrospective analysis of 26 cases" 116 : 194-197, 2004

12 Baker LR, "Idiopathic retroperitoneal fibrosis: a retrospective analysis of 60 cases" 60 : 497-503, 1987

13 Lepor H, "Idiopathic retroperitoneal fibrosis" 122 : 1-6, 1979

14 Comings DE, "Familial multifocal fibrosclerosis: finding suggesting that retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, Riedel's thyroiditis, and pseudotumor of the orbit may be different manifestations of a single disease" 66 : 884-892, 1967

15 Resnick MI, "Extrinsic obstruction of the ureter. In: Campbell's urology" Saunders 387-, 1996

16 Hall MC, "Diseases of the retroperitoneum. In Adult and pediatric urology" Mosby 1123-1158, 1996

17 Sassa H, "A case of idiopathic retroperitoneal fibrosis with chronic pericarditis" 31 : 414-417, 1992

18 윤기철, "A Case of Postrenal Acute Kidney Injury Complicating Retroperitoneal Fibrosis Associated with Autoimmune Pancreatitis" 대한신장학회 29 (29): 131-135, 2010