Aortic Aneurysm and Ureteral Obstruction Associated with Retroperitoneal Fibrosis and Arteritis. A Case Report and Literature Survey

Abstract

Idiopathic retroperitoneal fibrosis (IRF) is a rare disease of unknown etiol ogy. The disease is related to some therapeutic agents. Previously only in two cases methylopa has been associated with IRF. 4,5 The reported patient, a 56- year-old woman had suffered from arterial hypertension for 20 years and the only medication used was methyldopa for two years. A low back pain and a feeling of heaviness in her lower abdomen resulted in clinical examinations and an abdominal aortic aneurysm with moderate hydronephrosis on the right-hand side was found. IRF was revealed at operation. A ureterolysis and an aorto-iliac reconstruction were made using prosthesis. Postoperative recovery was un eventful. An inflammatory reaction in the outer part of the media and in the adventi tia of the aortic wall was found. The inflammatory cells were mostly lympho cytes and plasmacells but also some areas with heavy eosinophilic infiltrates were present. Vasculitis was seen in small vessels. Eleven cases of IRF associated with arteries from the previous literature are described.