症例報告後腹膜線維症にて急性腎不全を呈しステロイドが著効した二例

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We report two cases of retroperitoneal fibrosis. 1: A 78-years-old man was admitted to Totsuka Kyouritsu Daiichi Hospital with edema in the lower extremeties. On admission, bilateral pleural effusion was revealed by chest radiography and the palient's renal function had severely deteriorated (serum creatinine level: 9.9 mg/dl) . An abdominal computed tomographic scan showed the presence of a mass surrounding both the ureters and also bilateral hydronephrosis. 2: A 75-years-old man was admitted to Totsuka Kyoritsu Daiichi Hospital because of appetite loss and edema of the legs. The patient had undergone a surgical operation for an abdominal aortic aneurysm one year prior to admission. On admission, an abdominal computed tomographic scan showed the presence of a mass in the circumference of both the ureters. The serum creatinine level was 6.6 mg /dl. The diagnosis for both cases was retroperitoneal fibrosis, and prednisolone was initiated at the dose of 30 mg/day. Following treatment, the severity of fibrosis of the two cases decreased and the serum creatinine levels decreased to normal range. It has been reported that retroperitoneal fibrosis generally responds to high doses of corticosteroids. However, the two cases described in this paper responded to low doses of corticosteroids suggesting that even low doses for the initial treatment of retroperitoneal fibrosis should be considered.
学校法人昭和大学・昭和医学会の論文