急性腎不全を呈し薬物療法が著効した特発性後腹膜線維症の1例

Abstract

66歳男.後腹膜線維症の発症から約1ヵ月の経過で両側水腎症による急性腎不全を生じたが, 両側尿管カテーテル挿入とステロイド, 柴苓湯の投与により軽快した

We report a case of idiopathic retroperitoneal fibrosis in a 66-year-old man. He was admitted to our hospital because of acute renal failure, and emergent hemodialysis was performed. Computed tomography scanning showed a retroperitoneal mass surrounding the abdominal aorta and bilateral common iliac arteries. The mass involved bilateral ureters and acute renal failure was caused by bilateral hydronephrosis. Magnetic resonance imaging demonstrated that the mass was slightly high intensity on T2 weighted image. It was considered to be idiopathic retroperitoneal fibrosis. After inserting ureteral catheters into bilateral ureters, his renal function recovered. The layer of the fibrosis became thin by steroids and traditional Chinese medicine, and bilateral ureteral catheters could be removed two months later. At ten months after the treatment, no ureteral obstruction was observed and renal function is preserved.