Acute Kidney Failure in a Young African American Male
Retroperitoneal fibrosis (RPF) is a condition characterized by chronic inflammatory and fibrotic changes in the retroperitoneum that can lead to serious complications including kidney failure, mesenteric and limb ischemia, and deep venous thrombosis among others. Affected individuals may present wit...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2019/2591560 |
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| author | Thuan V. Nguyen Nada M. Bader Harpreet Sidhu Caprice Cadacio Susana M. Mendoza Phuong Thu T. Pham Phuong Chi T. Pham |
| author_facet | Thuan V. Nguyen Nada M. Bader Harpreet Sidhu Caprice Cadacio Susana M. Mendoza Phuong Thu T. Pham Phuong Chi T. Pham |
| author_sort | Thuan V. Nguyen |
| collection | DOAJ |
| description | Retroperitoneal fibrosis (RPF) is a condition characterized by chronic inflammatory and fibrotic changes in the retroperitoneum that can lead to serious complications including kidney failure, mesenteric and limb ischemia, and deep venous thrombosis among others. Affected individuals may present with nonspecific symptomology that would require a high clinical index of suspicion for prompt diagnosis. We herein discuss a case of a young African-American man with recurrent deep venous thrombosis who presents with a 4-week history of constant aching pain of abdomen and back and kidney failure. Initial noncontrast computed tomogram (CT) only revealed mild bilateral hydroureteronephrosis with inflammatory changes but without obvious mass or lymphadenopathy. At the insistence of the renal consulting team to rule out RPF, a CT-urogram was performed which revealed an infiltrative mass encasing the aorta, inferior vena cava, and common iliac vessels. Laparoscopic biopsy revealed dense fibroadipose tissue, lymphocytic aggregates, focal scattered IgG4-positive plasma cells, and fibrin deposition. Patient underwent bilateral nephrostomy placement and empirical corticosteroid therapy with resolution of kidney failure. Our case illustrates a classic presentation of RPF with relatively benign findings on noncontrast CT that could have been missed if clinicians did not keep a high index of suspicion for the condition. |
| format | Article |
| id | doaj-art-c4a5c331b422422aa62b79cd1edbfd8e |
| institution | OA Journals |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-c4a5c331b422422aa62b79cd1edbfd8e2025-08-20T02:18:46ZengWileyCase Reports in Nephrology2090-66412090-665X2019-01-01201910.1155/2019/25915602591560Acute Kidney Failure in a Young African American MaleThuan V. Nguyen0Nada M. Bader1Harpreet Sidhu2Caprice Cadacio3Susana M. Mendoza4Phuong Thu T. Pham5Phuong Chi T. Pham6Olive View-UCLA Medical Center, Division of Nephrology and Hypertension, Los Angeles, CA 91342, USAOlive View-UCLA Medical Center, Division of Nephrology and Hypertension, Los Angeles, CA 91342, USAOlive View-UCLA Medical Center, Division of Nephrology and Hypertension, Los Angeles, CA 91342, USAOlive View-UCLA Medical Center, Division of Nephrology and Hypertension, Los Angeles, CA 91342, USAOlive View-UCLA Medical Center, Division of Nephrology and Hypertension, Los Angeles, CA 91342, USADavid Geffen School of Medicine at UCLA, Kidney Transplant, Los Angeles, CA 90095, USAOlive View-UCLA Medical Center, Division of Nephrology and Hypertension, Los Angeles, CA 91342, USARetroperitoneal fibrosis (RPF) is a condition characterized by chronic inflammatory and fibrotic changes in the retroperitoneum that can lead to serious complications including kidney failure, mesenteric and limb ischemia, and deep venous thrombosis among others. Affected individuals may present with nonspecific symptomology that would require a high clinical index of suspicion for prompt diagnosis. We herein discuss a case of a young African-American man with recurrent deep venous thrombosis who presents with a 4-week history of constant aching pain of abdomen and back and kidney failure. Initial noncontrast computed tomogram (CT) only revealed mild bilateral hydroureteronephrosis with inflammatory changes but without obvious mass or lymphadenopathy. At the insistence of the renal consulting team to rule out RPF, a CT-urogram was performed which revealed an infiltrative mass encasing the aorta, inferior vena cava, and common iliac vessels. Laparoscopic biopsy revealed dense fibroadipose tissue, lymphocytic aggregates, focal scattered IgG4-positive plasma cells, and fibrin deposition. Patient underwent bilateral nephrostomy placement and empirical corticosteroid therapy with resolution of kidney failure. Our case illustrates a classic presentation of RPF with relatively benign findings on noncontrast CT that could have been missed if clinicians did not keep a high index of suspicion for the condition.http://dx.doi.org/10.1155/2019/2591560 |
| spellingShingle | Thuan V. Nguyen Nada M. Bader Harpreet Sidhu Caprice Cadacio Susana M. Mendoza Phuong Thu T. Pham Phuong Chi T. Pham Acute Kidney Failure in a Young African American Male Case Reports in Nephrology |
| title | Acute Kidney Failure in a Young African American Male |
| title_full | Acute Kidney Failure in a Young African American Male |
| title_fullStr | Acute Kidney Failure in a Young African American Male |
| title_full_unstemmed | Acute Kidney Failure in a Young African American Male |
| title_short | Acute Kidney Failure in a Young African American Male |
| title_sort | acute kidney failure in a young african american male |
| url | http://dx.doi.org/10.1155/2019/2591560 |
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