Niaz Azra, Ahmad Asad Hayat, Saeed Muhammed Ahmad, Sabir Omer, Tarif Nauman
Department of Medicine, Division of Nephrology, Fatima Memorial Hospital, Nur International University, Lahore, Pakistan.
Department of Pathology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan.
J Pak Med Assoc. 2016 Feb;66(2):220-2.
Idiopathic Retroperitoneal fibrosis is a rare clinical condition recently identified as an autoimmune process related to Immunoglobulin G4 (IgG4) deposition. Herein we report a case of a 46 year old male presenting with 4 months history of backache, fever, flank pain and leg swelling for 2 weeks. Investigations revealed acute kidney injury diagnosed as a result of bilateral ureteric obstruction. This was later confirmed to be retroperitoneal fibrosis on CT scan and biopsy. Histopathology was consistent with IgG4 related disease. Treatment with immunosuppressive agents showed reduction in the fibrosis and normalization of the kidney functions. We discuss the IgG4 related retroperitoneal fibrosis in detail along with its varied presentations.
特发性腹膜后纤维化是一种罕见的临床病症,最近被确认为与免疫球蛋白G4(IgG4)沉积相关的自身免疫过程。在此,我们报告一例46岁男性病例,该患者有4个月的背痛病史,发热、胁腹痛和腿部肿胀2周。检查发现急性肾损伤,诊断为双侧输尿管梗阻所致。后来CT扫描和活检证实为腹膜后纤维化。组织病理学与IgG4相关疾病一致。免疫抑制剂治疗使纤维化减轻,肾功能恢复正常。我们详细讨论了IgG4相关的腹膜后纤维化及其多样的表现。