Reactions 1704, p156 - 2 Jun 2018 Retroperitoneal fibrosis: case report An adult man [age at reaction onset not stated] developed retroperitoneal fibrosis (RPF) during long-standing treatment with etanercept for spondyloarthritis [route not stated]. The man was diagnosed with seronegative spondyloarthritis at the age of 31 years. He had received initial therapy for two years. However due to inefficacy, he was switched to etanercept 50 mg/week. Approximately ten years later, he developed acute low back pain with fever. Subsequent investigations revealed elevated acute phase reactants and raised creatinine level. An abdominal USG showed hydronephrosis and a CT scan revealed an enlarged left kidney caused by hydroureteronephrosis secondary to fibrotic stenosis of the ipsilateral ureter. The man was then admitted and subsequently underwent left ureterolysis and omentoplasty with insertion of double-J stent in the left ureter. A biopsy of the peritoneal and retroperitoneal tissue samples revealed a fibrotic tissue with marked chronic inflammatory changes, which was consistent with RPF. The etanercept therapy was discontinued, and he was treated with methylprednisolone. The low back pain resolved and the inflammatory markers were also normalised. The methylprednisolone therapy was tapered off simultaneously. Author comment: "Nonetheless, given the lack of knowledge about the pathogenesis of RPF and taking into account spondyloarthritis remission on adalimumab without worsening of RPF in our patient. . .a possible difference between etanercept and monoclonal antibodies (adalimumab and infliximab) in the development of RPF may be postulated." "Herein, we describe a case of RPF following a long-standing treatment with etanercept for spondyloarthritis." Manganelli S, et al. Retroperitoneal fibrosis following a long-standing etanercept treatment in a spondyloarthritis patient. Joint Bone Spine 85: 389-390, No. 3, May 2018. Available from: URL: https://doi.org/10.1016/j.jbspin.2017.05.024 - Italy 803323377 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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