Document Detail


Retroperitoneal fibrosis and ankylosing spondylitis: which links?
MedLine Citation:
PMID:  16084223     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To report a case of retroperitoneal fibrosis (RPF) in a patient with ankylosing spondylitis (AS) and to review the medical literature for similar cases to detect possible links between the 2 diseases. METHODS: The presentation, clinical course, diagnostic work-up, and treatment of our patient are described, and the English and French medical literature from 1960 to 2000 is reviewed using a MEDLINE search for cases with coexisting RPF and spondyloarthritis. RESULTS: Our patient with AS had RPF, which mimicked rectal cancer with retroperitoneal and vertebral metastases. Special attention is paid to the unusual clinical presentation, the multistep diagnostic process, and the therapeutic strategy which was both radiologically and histologically successful. Literature review revealed 18 cases of concomitant RPF and spondyloarthritis, mainly AS. Patients were more frequently male (M/F, 3/1) and developed spondyloarthritis several years before RPF. CONCLUSIONS: RPF may result from a local immune response to products of aortic atheromatous plaques, with subsequent periaortic deposition of fibrous tissue. However, the clinical features and the frequent association with other fibrosing disorders suggest that RPF is a systemic inflammatory condition. The role of AS-associated aortitis in the development of RPF warrants consideration.
Authors:
Antonella Afeltra; Umberto Vespasiani Gentilucci; Carla Rabitti; Antonio Amoroso; Marco Caricato; Marta Vadacca; Sergio Valeri; Enrico M Zardi; Roberto Coppola; Antonio Picardi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Seminars in arthritis and rheumatism     Volume:  35     ISSN:  0049-0172     ISO Abbreviation:  Semin. Arthritis Rheum.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-08     Completed Date:  2005-12-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306053     Medline TA:  Semin Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-8     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Immunology, and Rheumatology, University Campus Bio-Medico, 00155 Rome, Italy. a.afeltra@unicampus.it
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MeSH Terms
Descriptor/Qualifier:
Aortitis / complications,  pathology
Colonoscopy
Combined Modality Therapy
Diagnosis, Differential
Disease-Free Survival
Humans
Immunosuppressive Agents / therapeutic use
Male
Methotrexate / therapeutic use
Middle Aged
Prednisone / therapeutic use
Rectal Neoplasms / diagnosis
Retroperitoneal Fibrosis / complications,  pathology*,  therapy
Retroperitoneal Neoplasms / diagnosis,  secondary
Spinal Neoplasms / diagnosis,  secondary
Spondylitis, Ankylosing / complications,  pathology*,  therapy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 53-03-2/Prednisone; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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