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Retroperitoneal Fibrosis Due to Opium Abuse: A Case Series and Literature Review

View Article: PubMed Central - PubMed

ABSTRACT

Retroperitoneal fibrosis (RPF) is a rare condition with an unclear etiology, presenting with the development of aberrant chronic nonspecific fibroinflammatory tissue in the retroperitoneal space, which can result in entrapment and obstruction of the retroperitoneal structures. RPF is a subtype of chronic periaortitis, and can be divided into two types: primary (or idiopathic) and secondary. RPF is usually idiopathic, but can also be secondary to malignancies, certain drugs, infections, surgery, and trauma. The systemic clinical manifestations are nonspecific and include low-grade fever, fatigue, anorexia, weight loss, and myalgia. We report five patients admitted to our hospital with clinical, laboratory, imaging, and pathologic findings compatible with RPF, and we describe their treatment and follow-up. We were suspicious that the impurities of some types of opium have an important role in the pathogenesis of RPF. Some of our patients used opium again after the follow-up period; however, they used a different type with a different origin, and we were surprised to see that RPF did not form again.

No MeSH data available.


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Unilateral Hydronephrosis and Double-J Stent Insertion
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fig37357: Unilateral Hydronephrosis and Double-J Stent Insertion

Mentions: A 45-year-old man with a 3-year history of opium abuse presented with a 3-month history of left lower extremity edema. He had no previous history of any specific medical condition. Physical examination was normal, with a soft abdomen and normal bowel sounds. No pain was detected in the bilateral renal area. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) of 90 mm/h, and the complete blood count showed anemia with a hemoglobin of 11.2. Urine analysis was normal. Blood urea nitrogen (BUN) and serum creatinine were within normal range. Tumor markers, including CEA, CA125, αFP, and LDH were within normal limits. Ultrasonography detected unilateral hydronephrosis without ureteral dilation. Abdominal and pelvic computed tomography (CT) revealed an area of retroperitoneal thickness over the sacral promontory, with maximum thickness at the level of L4 - 5. Intravenous pylography (IVP) also revealed unilateral hydronephrosis (Figure 1).


Retroperitoneal Fibrosis Due to Opium Abuse: A Case Series and Literature Review
Unilateral Hydronephrosis and Double-J Stent Insertion
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5120253&req=5

fig37357: Unilateral Hydronephrosis and Double-J Stent Insertion
Mentions: A 45-year-old man with a 3-year history of opium abuse presented with a 3-month history of left lower extremity edema. He had no previous history of any specific medical condition. Physical examination was normal, with a soft abdomen and normal bowel sounds. No pain was detected in the bilateral renal area. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) of 90 mm/h, and the complete blood count showed anemia with a hemoglobin of 11.2. Urine analysis was normal. Blood urea nitrogen (BUN) and serum creatinine were within normal range. Tumor markers, including CEA, CA125, αFP, and LDH were within normal limits. Ultrasonography detected unilateral hydronephrosis without ureteral dilation. Abdominal and pelvic computed tomography (CT) revealed an area of retroperitoneal thickness over the sacral promontory, with maximum thickness at the level of L4 - 5. Intravenous pylography (IVP) also revealed unilateral hydronephrosis (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

Retroperitoneal fibrosis (RPF) is a rare condition with an unclear etiology, presenting with the development of aberrant chronic nonspecific fibroinflammatory tissue in the retroperitoneal space, which can result in entrapment and obstruction of the retroperitoneal structures. RPF is a subtype of chronic periaortitis, and can be divided into two types: primary (or idiopathic) and secondary. RPF is usually idiopathic, but can also be secondary to malignancies, certain drugs, infections, surgery, and trauma. The systemic clinical manifestations are nonspecific and include low-grade fever, fatigue, anorexia, weight loss, and myalgia. We report five patients admitted to our hospital with clinical, laboratory, imaging, and pathologic findings compatible with RPF, and we describe their treatment and follow-up. We were suspicious that the impurities of some types of opium have an important role in the pathogenesis of RPF. Some of our patients used opium again after the follow-up period; however, they used a different type with a different origin, and we were surprised to see that RPF did not form again.

No MeSH data available.


Related in: MedlinePlus