RESUMO
Retroperitoneal fibrosis (RPF) associated with chronic use of ergotamine is a very rare disorder. We report a 45-year-old woman who presented with a RPf after using, almost daily for 23 years, ergotamine tartrate for migraine relief. FRP presented as a chronic inflammatory state, anemia, abdominal and lumbosacral pain and a hypogastric mass. A CT-Scan showed a periaortic mass and left hydronephrosis. A percutaneous biopsy was obtained and the patient was subjected to a surgical ureterolysis and tissue resection. The biopsy confirmed the presence of RPf. Due to persistent symptoms and increase in the volume of periaortic tissue, treatment with colchicine 1 mg/day and defazacort 30 mg/day was started, resulting in a rapid disappearance of symptoms, disappearance of inflammation and a significant reduction in the volume of the periaortic tissue. The patient remains in complete remission after 29 months of follow up.
Assuntos
Analgésicos não Narcóticos/efeitos adversos , Ergotamina/efeitos adversos , Fibrose Retroperitoneal/induzido quimicamente , Analgésicos não Narcóticos/administração & dosagem , Colchicina/uso terapêutico , Ergotamina/administração & dosagem , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos de Enxaqueca/tratamento farmacológico , Prednisona/uso terapêutico , Fibrose Retroperitoneal/tratamento farmacológico , Fatores de TempoRESUMO
Retroperitoneal fibrosis (RPF) associated with chronic use of ergotamine is a very rare disorder. We report a 45-year-old woman who presented with a RPf after using, almost daily for 23 years, ergotamine tartrate for migraine relief. FRP presented as a chronicinflammatory state, anemia, abdominal and lumbosacral pain and a hypogastric mass. A CT-Scan showed a periaortic mass and left hydronephrosis. A percutaneous biopsy was obtained and the patient was subjected to a surgical ureterolysis and tissue resection. The biopsy confirmed the presence of RPf. Due to persistent symptoms and increase in the volume of periaortic tissue, treatment with colchicine 1 mg/day and defazacort 30 mg/day was started, resulting in a rapid di-sappearance of symptoms, disappearance ofinflammation and a significant reduction in the volume of the periaortic tissue. The patient remains in complete remission after 29 months of follow up.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Analgésicos não Narcóticos/efeitos adversos , Ergotamina/efeitos adversos , Fibrose Retroperitoneal/induzido quimicamente , Analgésicos não Narcóticos/administração & dosagem , Colchicina/uso terapêutico , Ergotamina/administração & dosagem , Transtornos de Enxaqueca/tratamento farmacológico , Prednisona/uso terapêutico , Fibrose Retroperitoneal/tratamento farmacológico , Fatores de TempoRESUMO
La fibrosis retroperitoneal idiopática es una entidad patológica histológicamente benigna aunque de curso habitualmente maligno, que se presenta en alrededor 1/200.000 habitantes, con predomino en hombres, con edad media de 50 a 60 años, cuya etiología sería inmunológica. Compromete preferentemente tejidos ubicados por debajo de la bifurcación aórtica y tejidos vecinos, siendo lo más frecuente el compromiso del o ambos uréteres. Su sistomatología es inespecífica y su diagnóstico es imagenológico e histopatológico. Su tratamiento es quirúrgico y medicamentoso en base a corticoides e inmunosupresores, aunque también se ha utilizado antiestrógenos como el tamoxifeno. Existe una forma de fibrosis retroperitoneal secundaria en alrededor del 33 por ciento de los pacientes, asociada al uso de algunos medicamentos y que mejora con la suspensión de éstos