Author(s): Scheel PJ Jr, Feeley N, Sozio SM
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Abstract BACKGROUND: Small case series suggest that a combination of mycophenolate mofetil and prednisone may be an effective treatment for patients with retroperitoneal fibrosis. OBJECTIVE: To describe the outcomes of adults with retroperitoneal fibrosis who received a combination of prednisone and mycophenolate mofetil. DESIGN: Prospective case series of patients followed between 1 April 2005 and 1 July 2009. SETTING: Single tertiary care facility. PATIENTS: 28 patients with retroperitoneal fibrosis. INTERVENTION: Prednisone, 40 mg/d, tapered over 6 months, and mycophenolate mofetil, 1000 mg twice daily, for a mean of 24.3 months. MEASUREMENTS: Clinical course, laboratory assessment, and measurement of periaortic mass. Mean follow-up was 1012 days, and no patients were lost to follow-up. RESULTS: Systemic symptoms resolved in all patients; 89\% had a 25\% or greater reduction in periaortic mass. Elevated erythrocyte sedimentation rate and serum creatinine level and decreased hemoglobin level normalized in all patients. Disease recurred in 2 of 28 patients. LIMITATION: This was a small case series. CONCLUSION: Combined prednisone and mycophenolate mofetil therapy is a potentially effective treatment for retroperitoneal fibrosis that warrants evaluation in randomized trials. PRIMARY FUNDING SOURCE: None.
This article was published in Ann Intern Med
and referenced in Journal of Clinical Case Reports