Into Clinical Practice: Diagnosis and Therapy of Retroperitoneal Fibrosis

Curr Rheumatol Rep. 2021 Feb 10;23(3):18. doi: 10.1007/s11926-020-00966-9.

Abstract

Purpose of the review: We aim to review the most relevant diagnostic features and treatment options of retroperitoneal fibrosis, in order to provide a useful guide for clinical practice.

Recent findings: The recent literature highlights the role of imaging studies such as computed tomography, magnetic resonance imaging and positron emission tomography as useful tools for the diagnosis of retroperitoneal fibrosis, with retroperitoneal biopsy being reserved to atypical cases. The treatment approach is mainly conservative and is based on the use of medical therapies plus urological interventions. Medical therapies essentially comprise glucocorticoids and immunosuppressants-either traditional or biological agents such as rituximab. Surgical ureterolysis is only left for refractory cases. Recent findings in retroperitoneal fibrosis highlight the possibility of a non-invasive diagnostic approach and a conservative treatment strategy.

Keywords: Autoimmunity; Glucocorticoids; IgG4; PET; Retroperitoneal fibrosis; Rituximab.

Publication types

  • Review

MeSH terms

  • Glucocorticoids / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Positron-Emission Tomography
  • Retroperitoneal Fibrosis* / diagnostic imaging
  • Retroperitoneal Fibrosis* / therapy
  • Tomography, X-Ray Computed

Substances

  • Glucocorticoids