DOI QR코드

DOI QR Code

Rapidly resolved IgG4-related retroperitoneal fibrosis after steroid pulse therapy

  • Jeung, Soomin (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hyosang (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seo, Yuri (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yoon, Hee-Young (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Nah Kyum (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Shinhee (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seo, Bomi (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Su-Yeon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Su-Kil (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2014.12.02
  • 심사 : 2015.02.25
  • 발행 : 2016.06.30

초록

Retroperitoneal fibrosis (RF) is a disorder characterized by the presence of a retroperitoneal mass and concurrent systemic inflammation. Some cases of RF are recognized as belonging to the spectrum of immunoglobulin G4-related disease (IgG4-RD). Glucocorticoids are highly effective for treatment of retroperitoneal fibrosis, although the optimal dose and duration of therapy have not been established. An initial dose of prednisone (40-60 mg) daily is usually administered with a tapering scheme. We report on a 55-year-old man diagnosed with IgG4-related RF and successfully treated with a 3-day course of daily 250 mg (4 mg/kg) intravenous methylprednisolone, which resulted in the prompt resolution of urinary obstruction and systemic symptoms.

키워드

참고문헌

  1. Pipitone N, Vaglio A, Salvarani C. Retroperitoneal fibrosis. Best Pract Res Clin Rheumatol 2012;26:439-48. https://doi.org/10.1016/j.berh.2012.07.004
  2. Vaglio A, Salvarani C, Buzio C. Retroperitoneal fibrosis. Lancet 2006;367(9506):241-51. https://doi.org/10.1016/S0140-6736(06)68035-5
  3. Vaglio A, Greco P, Corradi D, Palmisano A, Martorana D, Ronda N, et al. Autoimmune aspects of chronic periaortitis. Autoimmun Rev 2006;5:458-64. https://doi.org/10.1016/j.autrev.2006.03.011
  4. Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med 2012;366:539-51. https://doi.org/10.1056/NEJMra1104650
  5. Harreby M, Bilde T, Helin P, Meyhoff HH, Vinterberg H, Nielsen VA. Retroperitoneal fibrosis treated with methylprednisolon pulse and disease-modifying antirheumatic drugs. Scand J Urol Nephrol 1994;28:237-42. https://doi.org/10.3109/00365599409181272
  6. Obrencevic K, Jovanovic D, Kovacevic Z, Hrvacevic R, Ignjatovic L, Mijuskovic M. Mycophenolate mofetil combined with steroids: new experiences in the treatment of idiopathic retroperitoneal fibrosis. Vojnosanit Pregl 2007;64:385-90. https://doi.org/10.2298/VSP0706385O
  7. Parker BJ, Bruce IN. High dose methylprednisolone therapy for the treatment of severe systemic lupus erythematosus. Lupus 2007;16:387-93. https://doi.org/10.1177/0961203307079502
  8. Franchin G, Diamond B. Pulse steroids: how much is enough? Autoimmun Rev 2006;5:111-3. https://doi.org/10.1016/j.autrev.2005.08.003
  9. Kim HW, Park WJ, Cho SY. Idiopathic retroperitoneal fibrosis treated with high dose steroids. Korean J Nephrol 2005;24:1017-21. Korean.
  10. Fry AC, Singh S, Gunda SS, Boustead GB, Hanbury DC, McNicholas TA, et al. Successful use of steroids and ureteric stents in 24 patients with idiopathic retroperitoneal fibrosis: a retrospective study. Nephron Clin Pract 2008;108:c213-20. https://doi.org/10.1159/000119715
  11. Mackworth-Young CG, David J, Morgan SH, Hughes GR. A double blind, placebo controlled trial of intravenous methylprednisolone in systemic lupus erythematosus. Ann Rheum Dis 1988;47:496-502. https://doi.org/10.1136/ard.47.6.496
  12. Feduska NJ, Turcotte JG, Gikas PW, Bacon GE, Penner JA. Reversal of renal allograft rejection with intravenous methylprednisolone "pulse" therapy. J Surg Res 1972;12:208-15. https://doi.org/10.1016/0022-4804(72)90110-2
  13. Rose BD. Pathophysiology of renal disease. 2nd ed. New York: McGraw-Hill; 1987. p. 251.