Afeltra Antonella, Gentilucci Umberto Vespasiani, Rabitti Carla, Amoroso Antonio, Caricato Marco, Vadacca Marta, Valeri Sergio, Zardi Enrico M, Coppola Roberto, Picardi Antonio
Department of Internal Medicine, Immunology, and Rheumatology, University Campus Bio-Medico, 00155 Rome, Italy.
Semin Arthritis Rheum. 2005 Aug;35(1):43-8. doi: 10.1016/j.semarthrit.2005.03.003.
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.
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.
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.
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.
报告1例强直性脊柱炎（AS）患者并发腹膜后纤维化（RPF）的病例，并回顾医学文献中类似病例，以探寻这两种疾病之间可能存在的联系。
描述了我们这位患者的临床表现、临床病程、诊断检查及治疗情况，并通过检索MEDLINE数据库，对1960年至2000年英文和法文医学文献中RPF与脊柱关节炎并存的病例进行回顾。
我们这位AS患者患有RPF，其表现类似伴有腹膜后及椎体转移的直肠癌。特别关注了其不寻常的临床表现、多步骤诊断过程以及在放射学和组织学上均取得成功的治疗策略。文献回顾发现18例RPF与脊柱关节炎并存的病例，主要为AS。患者男性更为常见（男/女，3/1），且脊柱关节炎多在RPF出现前数年发生。
RPF可能是对主动脉粥样斑块产物的局部免疫反应导致，随后纤维组织在主动脉周围沉积。然而，其临床特征以及与其他纤维化疾病的频繁关联提示RPF是一种全身性炎症性疾病。AS相关主动脉炎在RPF发生过程中的作用值得考虑。
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