Retroperitoneal Fibrosis: Etiologic Considerations

Hoffman, William W.; Trippel, Otto H.

doi:10.1016/s0022-5347(17)65144-9

Cited by 89 publications

(13 citation statements)

References 23 publications

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“…The findings in this case support the suggestion of Hoffman and Trippel (1961) that idiopathic retroperitoneal fibrosis may be associated with a generalized vasculitis. It would seem that the vasculitis may affect primarily either the small muscular arteries, as in the cases of Hoffman and Trippel (1961) and Reidbord and Hawk (1965), or larger arteries as in the present case.…”

supporting

confidence: 90%

“…It would seem that the vasculitis may affect primarily either the small muscular arteries, as in the cases of Hoffman and Trippel (1961) and Reidbord and Hawk (1965), or larger arteries as in the present case. In the former instances there are features in common with polyarteritis nodosa.…”

mentioning

confidence: 60%

“…In the former instances there are features in common with polyarteritis nodosa. Indeed one case of polyarteritis nodosa in association with idiopathic retroperitoneal fibrosis has been observed (quoted by Ormond, 1962), and one of the cases of Hoffman and Trippel (1961) had renal vasculitis and perivasculitis with an eosinophilic infiltrate which were considered highly suggestive of polyarteritis nodosa. Reidbord and Hawk (1965) have also described renal involvement, the histology of the kidneys in their case showing a proliferative glomerulonephritis.…”

mentioning

confidence: 99%

“…The presence of a lymphocyte and plasma cell infiltrate in the lesion and the association of positive serological tests are consistent with a disturbance of immune mechanisms. The lesion has been discussed in the light of experimental work on hypersensitivity phenomena by Hoffman and Trippel (1961).…”

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Idiopathic Retroperitoneal Fibrosis Associated with an Arteritis

Jones

Alexander

1966

Ann Rheum Dis

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The first report in the world literature of the condition which is now generally known as idiopathic retroperitoneal fibrosis was that of Albarran (1905), but the first report in the English language did not appear until that of Ormond (1948). Since then many further case reports have been published, but the aetiology of the condition remains obscure.The disease usually presents as a urological problem when the mass of retroperitoneal fibrous tissue causes deviation or obstruction of one or both ureters often resulting in hydronephrosis. It has become apparent, however, that the manifestations of the disease may not be limited to the pressure effects of the retroperitoneal lesion on neighbouring structures and that the disease may present as a systemic disturbance.Case Report A 64-year-old man awoke on January 1, 1965, with severe low back pain which persisted and was made worse by movement. For 3 days the pain was so severe that he was almost completely immobilized. There were occasional sharp shooting pains down the back of both legs and his back tended to "lock" after sitting. Following the onset of the pain he complained of general malaise, anorexia, and night sweats. There were no urinary symptoms. He was admitted to hospital on January 16.During the previous 20 years he had had several attacks of low back pain, each of which had been much less severe than this attack.Examination.-He was a stocky man. A mid-stream specimen of urine contained no albumen or sugar and was normal on microscopy and sterile on culture.Chest x ray showed a normal cardiac shadow and slightly increased markings at the right lung base.Intravenous pyelogram showed partial obstruction and some hydronephrosis of the left kidney; the right kidney appeared normal. These findings were confirmed by retrograde pyelography.Course.-The patient ran a continuous fever of 990 to 1020 F. By February 10 the haemoglobin had fallen to 10-4 g./100 ml.A laparotomy was performed on February 22, when the presence of a dilated left renal pelvis and retroperitoneal fibrosis was confirmed and a biopsy of the lesion taken. Post-operatively the patient was apyrexial. On the third post-operative day he developed atrial fibrillation with a ventricular rate of 120 per min., which was confirmed electrocardiograwhically. He was given digitalis. The following day he developed severe pain in the left praecordium which radiated down the left arm. The pain lasted for 4 hours and was associated with a soft apical systolic murmur and a few rales at both lung bases. A further electrocardiogram showed that the rhythm had reverted to sinus, but there were supraventricular and ventricular ectopic beats and ST depression, most marked in lead V4. The following moming the serum SGOT was 79 units.Termination.-Later that morning (February 27) the patient collapsed suddenly. The peripheral pulses were not palpable and the electrocardiogram showed ventricular fibrillation. Resuscitative measures which included direct current defibrillation resulted in only temporary restoration of...

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Idiopathic Retroperitoneal Fibrosis Associated with an Arteritis

Jones

Alexander

1966

Ann Rheum Dis

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“…For example, hereditary cause [1], vasculitis [11], occlusive phlebitis [12], and inflammatory periaortitis [13] have been described. Idiopathic retroperitoneal fibrosis with ANCApositive vacuities has also been reported [14], suggesting the association with autoimmune disease.…”

Section: Discussionmentioning

confidence: 99%