%0 Journal Article
%T Fibrosis retroperitoneal primaria Primary retroperitoneal fibrosis
%A Edgar Lu赤s Morej車n Palacios
%A Mireya Mart赤nez Felipe
%A Sandra Rodr赤guez Hern芍ndez
%A Damaris Mar赤a Guzm芍n Mart赤nez
%J Revista Cubana de Medicina Militar
%D 2012
%I ECIMED
%X La fibrosis retroperitoneal es una enfermedad infrecuente con una epidemiolog赤a de 1/1 000 000 personas/a o, m芍s frecuente en el hombre que en la mujer, en la edad media de la vida y en el 75 % de los casos, es de causa primaria o desconocida. Paciente de 43 a os de edad, con antecedentes de salud, que acude al m谷dico de la familia con malestar general y dolor lumbar asociado a alteraciones del sedimento urinario que se interpret車 como infecci車n urinaria. Se comenz車 tratamiento antibi車tico con ciprofloxacino, sin mejor足a. Llega al cuerpo de guardia donde es atendido por la guardia de nefrolog赤a que indica an芍lisis complementarios de urgencia. Los resultados fueron: creatinina con valores de 1 024 米mol/L, acidosis metab車lica con ani車n gap elevado y ultrasonido con ri ones hidronefr車ticos. LLeva tratamiento con hemodi芍lisis en tres sesiones. En la discusi車n de caso complejo se valor車 el diagn車stico de fibrosis retroperitoneal, que se corroborr車 por tomograf赤a axial computarizada a las 72 h de su llegada al centro hospitalario. Se comenz車 tratamiento con metilprednisolona por 3 d赤as, seguido de prednisona y ciclofosfamida durante dos a os, con estudios de qu赤mica sangu赤nea, hemograma completo y estudios de orina en correspondencia con la respuesta al tratamiento. Se alcanza la remisi車n completa de la enfermedad sin reca赤das. Retroperitoneal fibrosis is a rare disease. Its epidemiology is a 1/1 million persons/year, It is more common in men than in women, ocuring in midle age, and its cause is primary or unknown in 75 % of cases. A 43 year-old patient, who had previous health history, referred to his family doctor not to feel well and with back pain associated with abnormalities of the urinary sediment, which was interpreted as urinary tract infection. Treatment started with ciprofloxacin antibiotic with no improvement. This patient was attended at nefrology guard, where emergency supplemental analysis were indicated. Results showed: creatinine values of 1024 micromol/L, high anion gap metabolic acidosis, and hydronephrotic kidney ultrasound. three hemodialysis sessions were indicated. At discussion of complex cases, a retroperitoneal fibrosis diagnosis was assessed, which was confirmed by CT scan at 72 hours of hospital arrival. Methylprednisolone therapy during three days was iniciated, followed by prednisone and cyclophosphamide for two years, with blood chemistry studies, complete blood count, and urine studies in correspondence with treatment response. complete remission of the disease without relapse was achieved.
%K fibrosis retroperitoneal
%K hemodi芍lisis
%K hidronefrosis
%K ciclofosfamida
%K metilprednisolona
%K prednisona
%K retroperitoneal fibrosis
%K hemodialysis
%K hydronephrosis
%K cyclophosphamide
%K methylprednisolone
%K prednisone
%U http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572012000400011